Center for Urban Education

Special Education Program

Apprenticeship Experience
Student Hillary Enyert____________________ Assigned Mentor Annea Green_____________________________________
Apprenticeship Assignment (Year One)_Ponderosa Elementary School____________________________________________________
Apprenticeship Assignment (Year Two)_Ponderosa Elementary School____________________________________________________
Apprenticeship Assignment (Year Three) Ponderosa Elementary School/immaron !iddle School _______________
Apprenticeship Assignment (Year "o#r)_Ponderosa Elementary School_______________________________________________________
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
0is#al *mpairment& incl#ding ,lindness Elementary !iddle High %& ' %& '
$ea+1,lindness Elementary !iddle High
Preschooler with a $isa,ility
2Setting ode3 % 4 General Ed#cation with S#pport5 ' 4 6eso#rce5 ( 4 Sel+1ontained5 ) 4 Other (please de+ine)
This +orm will ,e re7isited each year o+ yo#r program8