PARCCPortfolio Appeal Process

Appeal Cover Sheet

For each student appeal, the PARCC Portfolio Appeal must include the following items in their entirety:

A completed Appeal Cover Sheet (this document);

Education Proficiency Plan (EPP);

Student transcript; and

A Constructed Response Task Cover Sheetfor each test item in each subject area.(The Constructed Response Task Cover Sheet for each subject area can be found in the English Language Arts/Literacy (ELA/L) and Mathematics Information Guides.)

Student Appeal Process Information

Required Information / Information Provided
High school graduation date / Enter information here
Student name / Enter information here
SSID / Enter information here
County / Enter information here
School district / Enter information here
School name / Enter information here
School contact person (re: appeal) / Enter information here
Email address of contact person / Enter information here
Contact person’s phone number / Enter information here
Principal’s name / Enter information here
Principal’s email address / Enter information here

Please specify the content area(s) for this PARCC Portfolio Appeal by checking the appropriate box:

□English Language Arts only

□Mathematics Only

□Both ELA and Math

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New Jersey Department of Education PARCC Portfolio Appeal

Education Proficiency Plan (EPP) 2017-18

Student Name:

CDS Code: District Name: School Name:

In order to earn a New Jersey high school diploma, a student must demonstrate proficiency in both mathematics and English Language Arts/Literacy (ELA/L). A student may do this as explained in the High School Graduation Assessment Requirements document.

Part I. Student Assessment Information

This Educational Proficiency Plan is for this/these content area(s) – check those that apply:

□English Language Arts/Literacy

□Mathematics

□Both

Part I, continued

Tables 1 and 2 below are used to help school officials determine whether the student passed a graduation assessment in ELA/L or mathematics.

If the student was proficient in a particular subject, then no portfolio appeal is necessary for that subject.

Table 1: High School Graduation Assessments for English Language Arts/Literacy

English Language Arts/Literacy / Student Score / Pass? Y/N
PARCC ELA Grade 9 >= 750 (Level 4) or / Enter student score / Y/N
PARCC ELA Grade 10 >=750 (Level 4) or / Enter student score / Y/N
PARCC ELA Grade 11 >= 725 (Level 3) or / Enter student score / Y/N
Prior to 3/1/16 SAT Critical Reading >= 400or / Enter student score / Y/N
3/1/16 or later SAT Evidence-Based Reading and Writing Section >= 450 or SAT Reading Test >= 22or / Enter student score / Y/N
ACT Reading or ACT PLAN Reading >= 16 or / Enter student score / Y/N
Accuplacer Write Placer >= 6 or / Enter student score / Y/N
Accuplacer Write Placer ESL >= 4 or / Enter student score / Y/N
PSAT10 Reading or PSAT/NMSQT Reading* >=40 orPSAT10 Reading or PSAT/NMSQT Reading >=22or / Enter student score / Y/N
ACT Aspire Reading >= 422 or / Enter student score / Y/N
ASVAB-AFQT Composite >=31 or / Enter student score / Y/N
Meet the Criteria of the NJDOE Portfolio Appeal / Enter student score / Y/N

*Demonstrating alternative classroom work aligned to the New Jersey Student Learning Standards

Table 2: High School Graduation Assessments for Mathematics

Mathematics / Student Score / Pass? Y/N
PARCC Algebra I >= 750 (Level 4) or / Enter student score / Y/N
PARCC Geometry >= 725 (Level 3) or / Enter student score / Y/N
PARCC Algebra II >= 725 (Level 3) or / Enter student score / Y/N
Prior to 3/1/16 SAT Math >= 400or / Enter student score / Y/N
3/1/16 or later SAT Math Section >= 440
or SAT Math Test >= 22or / Enter student score / Y/N
ACT or ACT PLAN Math>= 16 or / Enter student score / Y/N
Accuplacer Elementary Algebra >= 76 or / Enter student score / Y/N
PSAT10 Math or PSAT/NMSQT Math*>= 40 or
PSAT10 Math or PSAT/NMSQT Math >=22or / Enter student score / Y/N
ACT Aspire Math >= 422 or / Enter student score / Y/N
ASVAB-AFQT Composite >=31 or / Enter student score / Y/N
Meet the Criteria of the NJDOE Portfolio Appeal / Enter student score / Y/N

*Demonstrating alternative classroom work aligned to the New Jersey Student Learning Standards

Part II. Student Courses

If a student needs a portfolio appeal for English Language Arts/Literacy, complete Table 3 below. If a student needs a portfolio appeal for mathematics, please complete Table 4 below. Tables 5 and 6 are used to measure proficiency in the New Jersey Student Learning Standards for ELA/L and mathematics; complete each table by listing the specific standard, the intervention to meet the standard, the evidence to be collected, and the target completion date.Please include a copy of the student’s transcript with the appeal.

Table 3: English Language Arts/Literacy (ELA/L) Courses

ELA/L Courses Taken / Grade Obtained / Areas of Strength / Areas That Need Improvement
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here

Table 4: Mathematics Courses

Mathematics Courses Taken / Grade Obtained / Areas of Strength / Areas Which Need Improvement
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here

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Table 5: English Language Arts/Literacy (ELA/L) Proficiency Plan

ELA/L
Focus Standard for Intervention / Describe Interventions / Describe Evidence to be
Collected to Determine
Proficiency in the Focus Standard / Targeted Date for Completion
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here

Table 6: Mathematics Proficiency Plan

Mathematics
Focus Standard for Intervention / Describe Interventions / Describe Evidence to be
Collected to Determine
Proficiency in the Focus Standard / Targeted Date for Completion
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here
Enter information here / Enter information here / Enter information here / Enter information here

Plan Agreement

Guidance or School Advisor Signature:

Teacher Signature:

Advisor Contact Name:

Advisor Phone: Advisor Email:

Education Proficiency Plan Completion Verification Section (required):

This student has completed all requirements of his/her plan:

Principal or designee name (printed):

Principal or designee signature: Date:

12/5/17