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CLASS

TEACHER
YEAR

Level 1

Level 3
Level 5
Level 1

6 Correct
5 Correct
4 Correct
3 Correct
2 Correct
1 Correct

Level 3

6 Correct
5 Correct
4 Correct
3 Correct
2 Correct
1 Correct
Level 5

4 Correct
3 Correct
2 Correct
1 Correct
Level 2

Level 4
Level 6
Level 2

6 Correct
5 Correct
4 Correct
3 Correct
2 Correct
1 Correct

Level 4

4 Correct
3 Correct
2 Correct
1 Correct
Level 6

4 Correct
3 Correct
2 Correct
1 Correct
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
Level 8

ee
ea
y
e
Level 8 Total: 0 0 0
Date of Assessment:
i
Level 9

igh
y
ie
i_e
Level 9 Total: 0 0 0
Date of Assessment:
Level 10

o
oa
ow
o_e
Level 10 Total: 0 0 0
Date of Assessment:
Level 11

a
ai
ay
a_e
Level 11 Total: 0 0 0
Date of Assessment:
Level 12

oo
ew
ue
u_e
Level 12 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
Level 8 Total

Level 9 Total

Level 10 Total

Level 11 Total

Level 12 Total
l

al

al

tal

tal
LEVEL 1 ### ### ### ### ### ###
Child 1 0 0 0 0 0 0
Child 2 0 0 0 0 0 0
Child 3 0 0 0 0 0 0
Child 4 0 0 0 0 0 0
Child 5 0 0 0 0 0 0
Child 6 0 0 0 0 0 0
Child 7 0 0 0 0 0 0
Child 8 0 0 0 0 0 0
Child 9 0 0 0 0 0 0
Child 10 0 0 0 0 0 0
Child 11 0 0 0 0 0 0
Child 12 0 0 0 0 0 0
Child 13 0 0 0 0 0 0
Child 14 0 0 0 0 0 0
Child 15 0 0 0 0 0 0
Child 16 0 0 0 0 0 0
Child 17 0 0 0 0 0 0
Child 18 0 0 0 0 0 0
Child 19 0 0 0 0 0 0
Child 20 0 0 0 0 0 0
Child 21 0 0 0 0 0 0
Child 22 0 0 0 0 0 0
Child 23 0 0 0 0 0 0
Child 24 0 0 0 0 0 0
Child 25 0 0 0 0 0 0
Child 26 0 0 0 0 0 0
Child 27 0 0 0 0 0 0
Child 28 0 0 0 0 0 0
Child 29 0 0 0 0 0 0
Child 30 0 0 0 0 0 0
No. of children with following scores:
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0

LEVEL 3 ### ### ### ### ### ###


Child 1 0 0 0 0 0 0
Child 2 0 0 0 0 0 0
Child 3 0 0 0 0 0 0
Child 4 0 0 0 0 0 0
Child 5 0 0 0 0 0 0
Child 6 0 0 0 0 0 0
Child 7 0 0 0 0 0 0
Child 8 0 0 0 0 0 0
Child 9 0 0 0 0 0 0
Child 10 0 0 0 0 0 0
Child 11 0 0 0 0 0 0
Child 12 0 0 0 0 0 0
Child 13 0 0 0 0 0 0
Child 14 0 0 0 0 0 0
Child 15 0 0 0 0 0 0
Child 16 0 0 0 0 0 0
Child 17 0 0 0 0 0 0
Child 18 0 0 0 0 0 0
Child 19 0 0 0 0 0 0
Child 20 0 0 0 0 0 0
Child 21 0 0 0 0 0 0
Child 22 0 0 0 0 0 0
Child 23 0 0 0 0 0 0
Child 24 0 0 0 0 0 0
Child 25 0 0 0 0 0 0
Child 26 0 0 0 0 0 0
Child 27 0 0 0 0 0 0
Child 28 0 0 0 0 0 0
Child 29 0 0 0 0 0 0
Child 30 0 0 0 0 0 0
No. of children with following scores:
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0

LEVEL 5 ### ### ### ### ### ###


Child 1 0 0 0 0 0 0
Child 2 0 0 0 0 0 0
Child 3 0 0 0 0 0 0
Child 4 0 0 0 0 0 0
Child 5 0 0 0 0 0 0
Child 6 0 0 0 0 0 0
Child 7 0 0 0 0 0 0
Child 8 0 0 0 0 0 0
Child 9 0 0 0 0 0 0
Child 10 0 0 0 0 0 0
Child 11 0 0 0 0 0 0
Child 12 0 0 0 0 0 0
Child 13 0 0 0 0 0 0
Child 14 0 0 0 0 0 0
Child 15 0 0 0 0 0 0
Child 16 0 0 0 0 0 0
Child 17 0 0 0 0 0 0
Child 18 0 0 0 0 0 0
Child 19 0 0 0 0 0 0
Child 20 0 0 0 0 0 0
Child 21 0 0 0 0 0 0
Child 22 0 0 0 0 0 0
Child 23 0 0 0 0 0 0
Child 24 0 0 0 0 0 0
Child 25 0 0 0 0 0 0
Child 26 0 0 0 0 0 0
Child 27 0 0 0 0 0 0
Child 28 0 0 0 0 0 0
Child 29 0 0 0 0 0 0
Child 30 0 0 0 0 0 0
No. of children with following scores:
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
### ### LEVEL 2 ### ### ###
0 0 Child 1 0 0 0
0 0 Child 2 0 0 0
0 0 Child 3 0 0 0
0 0 Child 4 0 0 0
0 0 Child 5 0 0 0
0 0 Child 6 0 0 0
0 0 Child 7 0 0 0
0 0 Child 8 0 0 0
0 0 Child 9 0 0 0
0 0 Child 10 0 0 0
0 0 Child 11 0 0 0
0 0 Child 12 0 0 0
0 0 Child 13 0 0 0
0 0 Child 14 0 0 0
0 0 Child 15 0 0 0
0 0 Child 16 0 0 0
0 0 Child 17 0 0 0
0 0 Child 18 0 0 0
0 0 Child 19 0 0 0
0 0 Child 20 0 0 0
0 0 Child 21 0 0 0
0 0 Child 22 0 0 0
0 0 Child 23 0 0 0
0 0 Child 24 0 0 0
0 0 Child 25 0 0 0
0 0 Child 26 0 0 0
0 0 Child 27 0 0 0
0 0 Child 28 0 0 0
0 0 Child 29 0 0 0
0 0 Child 30 0 0 0
No. of children with following scores:
0 0 1 0 0 0
0 0 2 0 0 0
0 0 3 0 0 0
0 0 4 0 0 0
0 0 5 0 0 0
0 0 6 0 0 0

### ### LEVEL 4 ### ### ###


0 0 Child 1 0 0 0
0 0 Child 2 0 0 0
0 0 Child 3 0 0 0
0 0 Child 4 0 0 0
0 0 Child 5 0 0 0
0 0 Child 6 0 0 0
0 0 Child 7 0 0 0
0 0 Child 8 0 0 0
0 0 Child 9 0 0 0
0 0 Child 10 0 0 0
0 0 Child 11 0 0 0
0 0 Child 12 0 0 0
0 0 Child 13 0 0 0
0 0 Child 14 0 0 0
0 0 Child 15 0 0 0
0 0 Child 16 0 0 0
0 0 Child 17 0 0 0
0 0 Child 18 0 0 0
0 0 Child 19 0 0 0
0 0 Child 20 0 0 0
0 0 Child 21 0 0 0
0 0 Child 22 0 0 0
0 0 Child 23 0 0 0
0 0 Child 24 0 0 0
0 0 Child 25 0 0 0
0 0 Child 26 0 0 0
0 0 Child 27 0 0 0
0 0 Child 28 0 0 0
0 0 Child 29 0 0 0
0 0 Child 30 0 0 0
No. of children with following scores:
0 0 1 0 0 0
0 0 2 0 0 0
0 0 3 0 0 0
0 0 4 0 0 0
0 0
0 0

### ### LEVEL 6 Err:509 Err:509 Err:509


0 0 Child 1 Err:509 Err:509 Err:509
0 0 Child 2 0 0 0
0 0 Child 3 0 0 0
0 0 Child 4 0 0 0
0 0 Child 5 0 0 0
0 0 Child 6 0 0 0
0 0 Child 7 0 0 0
0 0 Child 8 0 0 0
0 0 Child 9 0 0 0
0 0 Child 10 0 0 0
0 0 Child 11 0 0 0
0 0 Child 12 0 0 0
0 0 Child 13 0 0 0
0 0 Child 14 0 0 0
0 0 Child 15 0 0 0
0 0 Child 16 0 0 0
0 0 Child 17 0 0 0
0 0 Child 18 0 0 0
0 0 Child 19 0 0 0
0 0 Child 20 0 0 0
0 0 Child 21 0 0 0
0 0 Child 22 0 0 0
0 0 Child 23 0 0 0
0 0 Child 24 0 0 0
0 0 Child 25 0 0 0
0 0 Child 26 0 0 0
0 0 Child 27 0 0 0
0 0 Child 28 0 0 0
0 0 Child 29 0 0 0
0 0 Child 30 0 0 0
No. of children with following scores:
0 0 1 0 0 0
0 0 2 0 0 0
0 0 3 0 0 0
0 0 4 0 0 0
### ### ### ### ###
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
scores:
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

### ### ### ### ###


0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
scores:
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

Err:509 Err:509 Err:509 Err:509 Err:509


Err:509 Err:509 Err:509 Err:509 Err:509
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
scores:
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

l
CHILD NAME
GENDER
LEARNING DIFFERENCE
Please enter "y" or "n" for assessment result.
Date of Assessment:
s
m
Level 1

c
t
g
p
a
o
Level 1 Total: 0 0 0
Date of Assessment:
r
l
Level 2

d
b
f
h
i
u
Level 2 Total: 0 0 0
Date of Assessment:
v
w
Level 3

y
z
j
n
k
e
Level 3 Total: 0 0 0
Date of Assessment:
Level 4

ll
ss
f
zz
Level 4 Total: 0 0 0
Date of Assessment:
Level 5

sh
Level 5
ch
th
wh
Level 5 Total: 0 0 0
Date of Assessment:
Level 6

ck
ng
qu
x
Level 6 Total: 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
Level 1 Total

Level 2 Total

Level 3 Total

Level 4 Total

Level 5 Total
Level 5 Total

Level 6 Total
l

l
l

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