FDLRS Heartland Needs Assessment 09-10

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1. Level (Please check all that apply)

Level (Please check all that apply)   PreK

Elementary

K-8

Middle

High

Center School

Program Staff

2. District / County

District / County   DeSoto

Glades

Hendry

Highlands

3. Position (Please check all that apply)

Position (Please check all that apply)   Administrator Behavior Specialist Co-teacher Ed. Diagnostician ESE Dept. Chair ESE Program Specialist	ESE Resource Teacher ESE Self-contained Teacher General Ed Teacher Guidance Counselor OT/PT Paraprofessional	Psychologist Reading Coach SLP Social Worker
Other (please specify)

4. ESE Population you serve or teach (Please check all that apply)

ESE Population you serve or teach (Please check all that apply)   Autism Deaf/HH Educable Mentally Handicapped Emotional/Behavioral Disorder

Other Health Impaired Physically Impaired Profoundly Mentally Handicapped Specific Learning Disabilities

Speech/Language Impaired Trainable Mentally Handicapped Traumatic Brain Injury Visually Impaired

5. My name / contact information is: (optional)

My name / contact information is: (optional)