FLORIDA DEPARTMENT OF EDUCATION
Academic Achievement Through Language Acquisition
Office of The Chancellor, K-12 Public Schools
2005-2006 ELL/LEP STUDENT ALTERNATIVE ASSESSMENT
PRIMARY DISTRICT CONTACT
REPORTING FORM
Please use this form to report the contact information for the staff person you have
selected to be the primary contact person for reporting the ELL/LEP Alternative
Assessment Results.
District Name: ______________________
Date:________________
Name of Primary Contact: ________________________________________________
Mailing Address: ________________________________________________________
______________________________________________________________________
______________________________________________________________________
Email Address: _________________________________________________________
Phone Number: ________________________ Fax Number: __________________
Alternate Contact
Name of Alternate Contact: _______________________________________________
Mailing Address: ________________________________________________________
______________________________________________________________________
______________________________________________________________________
Email Address: _________________________________________________________
Phone Number: ________________________ Fax Number: __________________
PLEASE RETURN THIS FORM BY MARCH 24, 2006:
Via email to pat.faircloth@fldoe.org
- OR -
By fax to Pat Faircloth at 850-245-0846