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  A B C D E F G H I
1 Return completed form by November 30, 2003, to:                
2 Dr. Martha J. Miller, Policy Research and Improvement                
3 Florida Department of Education, 1501 Turlington   PUBLIC SCHOOLS STAFF SURVEY    
4 Tallahassee, FL 32399-0400   NEW HIRES - INSTRUCTIONAL PERSONNEL    
5 (850) 245-0404, SunCom 205-0404   (See Instructions)    
6 Martha.Miller@FLDOE.org                
7                  
8 District Number:     N E W H I R E S  
9 District Name:   Certified/Certifiable Not Certifiable in Appropriate Field    
10     Grades Grades Grades Grades    
11 Basic Assignments   PK-6 7-12 PK-6 7-12    
12 1. Self-Contained (Not PK/KG        
13 Including Exceptional 1-3        
14 Education) 4-6        
15 Grades Grades Grades Grades    
16 PK-5 6-12 PK-5 6-12    
17 2. English/Language Arts              
18 3. Mathematics              
19 4. Dropout Prevention              
20 5. Computer Science              
21 6. Social Studies              
22 7. Science              
23 8. Physical Education              
24 9. Reading              
25 10. Bilingual/ESOL              
26 11. Foreign Lanuages              
27 12. Health              
28 13. Art              
29 14. Music              
30                
31 Exceptional Student Education      
32 15. Preschool Handicapped              
33 16. Educable Mentally Handicapped              
34 17. Trainable Mentally Handicapped              
35 18. Physically Impaired              
36 19. Occupational Therapy              
37 20. Physical Therapy              
38 21. Speech/Language Impaired              
39 22. Hearing Impaired              
40 23. Visually Impaired              
41 24. Emotionally Handicapped              
42 25. Specific Learning Disabled              
43 26. Gifted              
44 27. Homebound/Hospitalized              
45 28. Varying Exceptionalities              
46 29. Profoundly Handicapped              
47                
48 Vocational      
49 30. Agribusiness Education              
50 31. Business and Office Education              
51 32. Marketing Education              
52 33. Health Occupations Education              
53 34. Public Service Education              
54 35. Home Economics Education              
55 36. Industrial Education              
56 37. Technology Education/Industrial Arts              
57                  
58 Others - Indicate on Page 3      
59                  
60 Name of Person Completing This Form:                
61 Phone/Suncom: ( )                
62 E-mail:                
63                
64                
65 ESE 058              
66 Exp. 08/31/04 DOE Page 1 of 2 Florida Department of Education    
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  A B C D E F G
1 Return completed form by November 30, 2003, to:            
2 Dr. Martha J. Miller, Policy Research and Improvement            
3 Florida Department of Education, 1501 Turlington PUBLIC SCHOOLS STAFF SURVEY  
4 Tallahassee, FL 32399-0400 NEW HIRES - INSTRUCTIONAL PERSONNEL  
5 (850) 245-0404, SunCom 205-0404 (See Instructions)  
6 Martha.Miller@FLDOE.org            
7              
8 District Number:   N E W H I R E S  
9 District Name: Certified/Certifiable Not Certifiable in Appropriate Field  
10   Grades Grades Grades Grades  
11   PK-6 7-12 PK-6 7-12  
12 Other - Classroom  
13 38. Adaptive Physical Education          
14 39. Adult Education          
15 40. Alternative Education          
16 41. Autistic          
17 42. Career Educ./Career Specialist          
18 43. Critical Thinking          
19 44. Dance          
20 45. Drama          
21 46. Driver Education          
22 47. In-school Suspension          
23 48. Life management          
24 49. ROTC          
25 50. Title 1          
26              
27 Other Classroom - List Below  
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39 Other Instructional & Support  
40 51. Behavior Specialist          
41 52. Curriculum Resouce Teacher          
42 53. Curriculum Coordinator          
43 54. ESE Liaison          
44 55. Family Counselor          
45 56. Guidance Counselor          
46 57. Home-School Liaison          
47 58. Librarian, Media Specialist          
48 59. Occupational Specialist          
49 60. Permanent Substitutes          
50 61. Resource Teacher          
51 62. School Psychologist          
52 63. Social Worker          
53              
54 Other Instructional - List Below  
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65              
66 ESE 058 DOE Page 2 of 2            

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