MIT Data Collection Form

MIT Data Form

If you are a new or replacement MIT, please skip the section on previous training activities.
If you do not plan to serve as an MIT during the 2008/2009 school year, please skip the section on upcoming plans.

First Name:

Last Name

School:

District:

Initial Grant Year:

2006/Round 1
2007/Round 2
2008/Round 3

Years of intervention teaching completed as of June 2008:

0 Years
1 Year
2 years

MIT school email address:

MIT other email address:

School address:

School city:

School state:

School zip:

School phone number:

Other phone number(s):

Principal first name:

Principal last name:

Principal email address:

Other administrator first name:

Other administrator last name:

Other administrator email address:

2007/2008 Core Math Program:

2008/2009 Core Math Program:

Does your school have Title 1 status for more then 40% f/r lunch?

Yes No

PAST (current MITs only)

Intervention program(s) with grade levels implemented in 2007/2008 (Math Recovery One-on-One, Math Recovery Group, Add+Vantage MR, Success Maker, Number Worlds Original Version, Number Worlds Pilot Version, Other, n/a)

Approximate number of intervention students per grade level for 2007/2008:

K: 1st: 2nd: 3rd:

Do you plan to continue in 2008/2009?

Yes No

If not, please give the reason for leaving:

Moving
Retiring
Reassigned to Classroom
Other

Please confirm your training attendance from June 1, 2007 to May 30, 2008 by entering the number of day or half days for the events you attended:

5 days of NEW MIT Number Worlds Training, July 2007, Hopkinsville

Enter number of days

3 days of Advanced Number Worlds Training, July 2007, Hopkinsville

Enter number of days

5 days of Math Recovery Specialist Training, June 2007, Frankfort

Enter number of days

3 days of Advanced Math Recovery Specialist Training, June 2007, Frankfort

Enter number of days

3 days of Math Recovery Specialist Training, September 2007, Highland Heights

Enter number of days

2 days of Kentucky Council of Teachers of Mathematics Conference, October 2007, Lexington

Enter number of days

2 days of Math Recovery Specialist Training, November 2007, Highland Heights

Enter number of days

3 days of Math Solutions Training, November 2007, Newport

Enter number of days

1.5 days of Landscape of Intervention Training, February 2008, Newport

Enter number of days

2 days of Kentucky Teaching and Learning Conference, March 2008, Louisville

Enter number of days

2.5 days of National Council of Teachers of Mathematics Conference, April 2008, Salt Lake City

Enter number of days

1 day of Math Recovery Conference pre-session, April 2008, Covington

Enter number of days

2.5 days of Math Recovery Conference, April 2008, Covington

Enter number of days

Math Recovery Collegial Team Meetings:

0.5 day, November
0.5 day, January
0.5 day, March
0.5 day, May (online)

Weekly Centra meetings:

Weekly, (consistent attendance, occasional attendance, infrequent attendance)

Monthly (consistent attendance, occasional attendance, infrequent attendance)

Weekly, (consistent attendance, occasional attendance, infrequent attendance)

Monthly, (consistent attendance, occasional attendance, infrequent attendance)

Other

Enter number of days

Please list workshops or sessions you have presented or co-presented for colleagues:

Topic Event Session Length Month/Year Location

Future Plans:

Intervention program(s) with grade levels planned for implementation in 2008/2009

Math Recovery One-on-One
Math Recovery Group
Add+Vantage MR
Success Maker
Number Worlds Original Version
Number Worlds Pilot Version
Other
n/a

Approximate number of intervention students per grade level for 2008/2009:

K: 1st: 2nd: 3rd:

Primary universal pre-screening tool for fall 2008:

Terra Nova
GMADE
MAP
Other

Check the events you plan to attend during summer 2008
You will need to register for these events separately at http://kymath.org/registrations

If you have any questions regarding this data collection, please contact Alice Gabbard or Jonathan Thomas.