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What practices/strategies will the member use to assist the student? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________)The student's attitude toward reading is $Teacher Referral and Assessment FormStudent's Grade (K-12):#Student's Name or Identifying Code:3Subject area that the student is being tutored in: School Name:kHow would you describe the student's CURRENT skill performance in the designated subject area (circle one)?Slightly Below Grade Level Compared to when the student began working with the AmeriCorps member, please describe the student's performance in the designated subject area (circle one).žMuch Improved Improved The Same cMuch Improved Improved The Same ’Much Improved Improved The Same š 4 3 2 1(Instructions: Please take a few minutes to fill out this Referral and Survey Form for each student being tutored by an AmeriCorps member. The information you provide will help the Washington Service Corps assess the impact our members are having on the students with whom they work. Thank you! ЃCompared to when the student began working with the AmeriCorps member, please describe the student's skill performance in the designated subject area (circle one).\INITIAL ASSESSMENT of student performance prior to working with the AmeriCorps memberyMID-YEAR ASSESSMENT of student performance after working with the AmeriCorps member by [Insert Due Date]žFINAL ASSESSMENT of student performance after working with the AmeriCorps member by [Insert Due Date] 1). 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