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NEW YORK CITY PERIODIC ASSESSMENT PROGRAM
ACUITY ASSESSMENTS
CLASS ROSTER SHEET
DBN
TYPE OF ASSESSMENT (circle one)

PREDICTIVE

GRADE (circle one)
SUBJECT (circle one)

3

4

ITA
5

MATHEMATICS

6

7

8

9

10

11

ENGLISH LANGUAGE ARTS

TEST ID (one per Class Roster)
ASSESSMENT ADMINISTRATION DATE(S)
EDUCATOR NAME

CLASS ID

TOTAL # OF STUDENTS

Please list below the names of students who were administered the assessment.
1.

13.

25.

2.

14.

26.

3.

15.

27.

4.

16.

28.

5.

17.

29.

6.

18.

30.

7.

19.

31.

8.

20.

32.

9.

21.

33.

10.

22.