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District 75 Forms

District 75 Forms & Files

 Academic Intervention Services/Teacher Development

 Arts

Autism

Counseling

District 75 General Forms

 Health Services

 Hearing

 Inclusive Education

Interpreting Services

 Literacy 

 Mathematics

 Multiple Disabilities

Office of Related & Contractual Services (ORCS)

  Speech    

AIS - General Forms & Files

 Title  Download Size 
AIS Discontinuance Parent Letter .doc  28K
AIS Initiation Parent Letter .doc  28K
Academic Intervention Team Binder .doc  34K
Academic Intervention Team Plan .doc  41K
NYS High School Diploma Requirements Chart .pdf 21K
Student Referral Form .doc  30K
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AIS Checklists

Title Download Size

Elementary Portfolio Checklist

 .doc  35K
Middle School Portfolio Checklist .doc  31K
High School Portfolio Checklist .doc  32K
Study Skills Checklist for Secondary School .doc  38K
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AIS - Great Leaps Forms

Title Download Size
Great Leaps - Reading .pdf 277K
Great Leaps Scoring Guide .doc 51K
Great Leaps Charting (Student) .doc 48K
Great Leaps Charting (Teacher) .doc 114K
Great Leaps to Remember .doc 31K
Great Leaps Certificate .doc 89K
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AIS - Personal Intervention Plan (PIP) Forms

Title Download  Size
PIP 2010-2011 .doc 69K
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AIS - Promotion in Doubt Forms

Title Download Size
Promotion Policy .pdf  168K
Promotion in Doubt ATS Procedures .doc  28K
NYCDOE PID Letters Page (from DOE intranet only) .htm  
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Arts

 Title  Download   Size 
 Permission to Photograph, Film, or Videotape Students  .htm    
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Arts - CASTA: Communication and Socialization Through the Arts: A Multidisciplinary Approach for Students with Autism

 Title  Download   Size 
 CASTA Workshop 1  .pdf   331K
 CASTA Workshop 2  .pdf   528K
 CASTA Workshop 3  .pdf   160K
 CASTA Workshop 4  .pdf   175K
 CASTA Workshop 5  .pdf   112K
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Arts - CIAE: Creative Integrative Arts Educators Music Theater Curriculum Guide

 Title  Download  Size
 CIAE Complete Curriculum  .pdf   2.3M
 CIAE Documentation and P.R.  .pdf   1.1M
 CIAE Drama  .pdf   419K
 CIAE Movement  .pdf   153K
 CIAE Music  .pdf   176K
 CIAE Visual Arts  .pdf   176K
 CIAE Writing  .pdf   295K
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Arts - Strategies and Ideas for Music Teachers

 Title  Download  Size
 Sound and Silence (Go and Stop)  .pdf   39K
 Orchestration  .pdf   52K
 Dynamics  .pdf   55K
 Tempo  .pdf   52K
 Pitch  .pdf   41K
 Rhythm  .pdf   58K
 Stories  .pdf   40K
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Autism

Title Download  Size 
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Counseling

Title Download  Size 
ACS Directory of Borough Commisioners (Revised 5/14/10) .pdf Adobe Acrobat 48K
ACS Borough Email List LDSS-2221A (revised 11/24/09) .pdf Adobe Acrobat 21K
ACS - CityWide Managerial Roster 3-2009 .pdf Adobe Acrobat 129K
Anti Bullying Resources .doc  23K
Behavior Intervention Planning in SESIS .pdf Adobe Acrobat 75K
Child Abuse Phone Listing .doc  49K
Counseling Instructions .doc  29K
Developmental Disabilities Services Offices (DDSO) .doc  19K
Educational Neglect Policy .pdf Adobe Acrobat 639K
Form A: Suicide Prevention Reporting Form .doc  45K
Functional Behavior Analysis in SESIS .pdf Adobe Acrobat 89K
IEP Crosswalk .ppt  4M
Indirect Counseling Service Report (revised) .doc  92K
Letter to Providers 3/31/2011 .pdf Adobe Acrobat 2M
NYC Clinics 3/21/2011 (See Letter to Providers) .pdf Adobe Acrobat 100K
Mobile Crisis Team Directory .pdf Adobe Acrobat 152K
OCGS Daily Log .doc  97K
Reporting Chart .doc  87K
Request for Release of Records .doc  65K
Schedule - Counseling (revised) .doc  112K
SESIS IEP Refinement .ppt  1.5M
Sexual Harassment 1 .doc  80K
Sexual Harassment 2 .doc  82K
Sexual Harassment 3 .doc  79K
Sexual Harassment 4 .doc  80K
SOPM 08 .pdf Adobe Acrobat 2M
Suicide Hotline Presentation .pdf Adobe Acrobat 81K
Suspected Child Abuse or Maltreatment Report LDSS_2221A .doc  188K
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Counseling - Chancellor's Regulations

Title Download Size
A-420 Pupil Behavior & Discipline-Corporal Punishment .pdf Adobe Acrobat 221K
A-421 Pupil Behavior and Discipline-Verbal Abuse .pdf Adobe Acrobat 60K
A-740 Pregnant And Parenting Students And Reproductive Health Privacy .pdf Adobe Acrobat 3M
A-750 Reports of Suspected Child Abuse .pdf Adobe Acrobat 1.2M
Highlight of CRA-750 The Blue Card (Note: print on blue card stock) .pdf Adobe Acrobat 1.1M
A-755 Suicide Prevention/ Intervention .pdf Adobe Acrobat 92K
A-831 Student to Student Sexual Harassment .pdf Adobe Acrobat 530K
Student to Student Biased Based Harassment, Intimidation and/or Bullying .pdf Adobe Acrobat 327K
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General

Title Download Size
Committee for Special Education (CSE) Contacts .pdf Adobe Acrobat 22K
Discharge Codes .pdf Adobe Acrobat 27K
District 75 Academic and Behavioral Interventions .pdf Adobe Acrobat 107K
District 75 Administrative Handbook .pdf Adobe Acrobat 901K
District 75 Continuum of Programs and Services .pdf Adobe Acrobat 215K
DOE Office of Special Education Educator Resources .htm web page  
Procedures for Emergencies .doc  80K
The Quality Review: A Reflection .pdf Adobe Acrobat 175K
SIE Categories .pdf Adobe Acrobat 24K
Staffing Ratios Defined (e.g., 6:1:1, 12:1:4) .pdf Adobe Acrobat 21K
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Health Services

Title Download Size
Office of School Health Contact Numbers .pdf Adobe Acrobat 27K
Blood-borne Pathogens Training Slide show .ppt  424K
Hazard Communication - Right-to-Know .ppt  242K
Blood-borne Pathogens/Hazard Communications Procedures (see also OOSH) .pdf Adobe Acrobat 43K
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Hearing Education Services (HES)

Title Download Size
Hearing Education Services (HES) Brochure .doc  376K
.pdf  227K
HES Audiologists List .doc  28K
.pdf  11K
Audiology Brochure .pdf  229K
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Inclusive Education

Inclusive Education - Articulation

Title Download Size
Student Profile .doc  73K

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Inclusive Education - Best Practices

Title Download Size
Matrix of Program Quality Indicators for Students with Disabilities In Inclusive Schools .doc  33K
Inclusive Environment Checklist .doc  63K
IEP at a glance .doc  35K
Teacher's Inclusion To-Do List .doc  32K
Administrator Guidelines for Developing Inclusive Education .doc  58K
.pdf  56K
Principal's Inclusion To-Do List .doc  43K
.pdf  22K
SESIS D75 SETSS Recommendation Reference Guide .pdf  53K
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Inclusive Education - District 75 Inclusive Programs

Title Download Size 
2011-12 Maps .pdf  81K
Choice Form .doc  29K
Directory of New York City Public High Schools with District 75 SETSS Programs 2011-2012 .pdf  1.0M
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Inclusive Education - General Documents

Title Download Size 
A Day in the Life of Being in Inclusion .pdf  5K
District 75 SETSS Provider Model .pdf  23K
District 75 PD Calendar 2011-12 .pdf  431K
Funding for Students Receiving District 75 SETSS Supports .pdf 

145K

My Positive Experience with Inclusion ,pdf  123K
SETSS Mandates Form 2011 .doc  15K
Story Told by Marc Mendez .pdf  55K
What is Inclusion? .pdf  47K
YAI "Progress in Inclusion" Newsletter August 2011 .pdf  673K

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Interpreting Services

Title Download Size
Interpreting Services Brochure .pdf  120K
Sign Language Interpreter Request Form .pdf  101K
Sign Language Observation Request Form .pdf  118K
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Literacy

Title Download Size 
Boardmaker Literacy Project Rubric .pdf  226K
Literacy Walkthrough Checklist .xls  37K
Poetry Presentation (April is Poetry Month) .pdf  740K
Project-Based & Community-Based Instruction .pdf  1.2M
Technology-Infused Nonfiction Writing Unit .doc  2M
What Do You Do When You Get Stuck on A Word? .ppt  89K
.pdf  241K
Working with Words 1 .ppt  68K
.pdf  140K
Working with Words 2 .ppt  67K
.pdf  140K
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Literacy - Libraries

Title Download Size 
E-Books .doc  78K 
.pdf  40K
Information Literacy Agenda
 		 .doc  80K
.pdf  34K
Self-Evaluation Process for Primary School Libraries .pdf  172K
Self-Evaluation Process for Secondary School Libraries and Learning Resource Centers .pdf  161K
TeachingBooks.net Information .pdf  25K
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Mathematics

Title Download Size
Common Core - P-12 Learning Standards in Mathematics .pdf  634K
2009 Impact Mathematics Course 1 .pdf  104K
2009 Impact Mathematics Course 2 .pdf  61K
2009 Impact Mathematics Course 3 .pdf  120K
Information about Everyday Math Online Games .doc  41K
Marilyn Burns/Math Solutions .doc  40K
.pdf  27K
Math in Focus Flowchart .ppt  702K
Math in Focus Overview .ppt  759K
Math Journal Questions .doc  11K
Math Toolkit Summary .doc  195K
New High School Curriculum .doc  40K
.pdf  20K
Workshop Model .pdf  13K
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Multiple Disabilities

Title Download Size
Classroom Practices for Students with Multiple Disabilities .doc  37K
.pdf  24K
Continuum of Programs and Services in District 75 .doc  90K
.pdf  215K
IndTECH Catalog 2011-12 .pdf  4.2M
Medical Conditions and Their Effects on Learning .pdf  94K
Promoting Access for 12:1:4 Classrooms .pdf  353K
Typical 12:1:4 Students .pdf  111K
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Multiple Disabilities - Brigance Forms

Title Download Size 
Directions for Assigning Item Codes .pdf  140K
Sample Coding Activity .pdf  497K
Activity Sheets: Speech and Language Skills .pdf  116K
Activity Sheets: General Knowledge and Comprehension .pdf  143K
Activity Sheets: Basic Math .pdf  115K
Activity Sheets: Math Grade Placement .pdf  158K
Activity Sheets: Numbers .pdf  151K
Activity Sheets: Time-Money .pdf  158K
Activity Sheets Complete .pdf  1.4M
Assessment Considerations Checklist .doc  58K
Brigance Manual - Electronic 2008-2009 .doc  253K
.pdf  256K
Brigance Manual - Regular 2008-2009 .doc  211K
.pdf  201K
Brigance Table of Contents .doc  205K
.pdf  439K
Labels .pdf  93K
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Office of Related and Contractual Services (ORCS)

Title Download Size
RSA-3 Form - Transportation Reimbursement Voucher Public Transportation, Private Car or Metered Taxi Cab .doc  100K
RSA-3a Form - Transportation Reimbursement Voucher Private Car Services .doc  94K
W-9 Form .pdf  354K
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Speech Services

Title Download  Size 
Administrative Timeline .pdf  83K
Agenda - September 2011
Assistive Technology Flowchart for Staff .pdf  13K
Caregiver Mealtime Interview .pdf  71K
Classroom Communication Systems .doc  33K
Clinical Record Book Cover Sheet .pdf  20K
Collaborative & Class Trip Lesson Plans .doc  33K
Collaborative Lesson Plan for JARs .doc  32K
Communication Boards Support - Generic Comm Wallet 1 .pdf  337K
Communication Boards Support - Generic Comm Wallet 2 .pdf  224K
Communication Dictionary Information Form .doc  33K
Contracted Service Parent Letter .pdf  161K
CSS Communication Profile .pdf  292K
CSS Speech Evaluation Outline .pdf  13K
D75 Administrator & SPED Liaison SESIS Training .pdf  688K
Eating Skills Screening .pdf  118K
End of Year Procedures .pdf  70K
End of Year Summary .pdf  127K
First-Then .doc  38K
Give Me 20 Main Board (White) .pdf  52K
IEP Driven Device Provider Survey .pdf  29K
IEP Refinements Cheat Sheet .pdf  737K
Interim Service Plan .pdf  1M
Intervention Plan .doc  30K
Intervention Plan 2 .doc  31K
Intervention Plan 3 .doc  30K
Intervention Plan 4 .doc  48K
Introducing Chewables .pdf   26K
Key Questions .pdf  58K
Mandate Modification/Termination Form .doc  41K
Mealtime Plan 2011-2012 .doc  28K
Mealtime Plan Checklist .pdf  75K
Mealtime Plan Form .doc  28K
Mini Supersymbols .pdf  301K
ORCS/IVR FAQs .pdf  187K
Personnel Data Form .pdf  81K
Professional Log .doc  37K
Pro-Ed Speech Speech and Language Development Chart .pdf  106K
Recording a Service in SESIS Job Aid .pdf  69K
Referring Students for Assistive Technology in SESIS .pdf  184K
Related Service Provider Schedule .doc  69K
SESIS Encounter Attendance .pdf  737K
Steps for Creating a Mealtime Plan .pdf  205K
Supervisor Locations & Contact Information 2011-12 .pdf  52K
Task Analysis Worksheet .doc  33K
Transmittal Request .doc  33K
Viewing & Editing Your Caseload in SESIS .pdf  28K
Visitation Form .doc  28K
What I Worked On .doc  28K
What We Are Working On .doc  297K

    District 75  |  400 First Avenue, New York, NY 10010  |  (212) 802-1500  |  Contact