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Center for Urban Education Special Education Program Apprenticeship Experience Student Daphnie Peterson Assigned Mentor

Apprenticeship Assignment (Year One)_ Eaglecrest High School Apprenticeship Assignment (Year Two)_ Eaglecrest High School Apprenticeship Assignment (Year Three)_ Red Hawk Ridge Elementary Apprenticeship Assignment (Year Fo r)___Red Hawk Ridge Elementary _________________________________________________________________________________ You may list additional Apprenticeship Assignments (e.g., Extended School Year) on the back of this form.

This form must be turned in at the end of each year. Please include a copy of this form in your portfolio. Colorado Disability Categories Grade e!el "ear #$% &% '% () Setting*
#$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& #$%$& A tism Spectr m !isorder Elementary "iddle High #$%$&$' Hearing (mpairment$ incl ding dea)ness Elementary "iddle High %$&$' Serio s Emotional !isa*ility Elementary "iddle High #$%$&$' (ntellect al !isa*ility Elementary "iddle High #$%$&$' " ltiple !isa*ilities Elementary "iddle High #$%$&$' Orthopedic (mpairment Elementary "iddle High #$%$& Other Health (mpairment Elementary "iddle High #$%$&$' Speci)ic +earning !isa*ility Elementary "iddle High #$%$&$' Speech or +ang age (mpairment Elementary "iddle High #$%$&$' Tra matic ,rain (n- ry Elementary "iddle High #$%$& .is al (mpairment$ incl ding *lindness Elementary "iddle High #$%$&$' !ea)/*lindness Elementary "iddle High #$%$& 0reschooler with a !isa*ility 1Setting 2ode3 # 4 5eneral Ed cation with S pport6 % 4 Reso rce6 & 4 Sel)/2ontained6 ' 4 Other (please de)ine)

This )orm will *e re7isited each year o) yo r program8