Evidence of Assessments (EAs) : Checklist

CHECKLIST FOR COLLECTION OF STUDENT DATA - SBA - SCHOLASTIC

CLASS X: 2012-13

Actual Form: www.icbse.com/forms/cbse/evidence-of-assessment.pdf

1. School Details

i) Name of the School (with Complete Address) providing samples to the Regional Office : ..............................................

ii) School Number: .................................................

ii) Name of the Principal: ............................................

iii) Phone No. (School): ..................................................

iv) Fax No.: .................................................

v) Mobile No.: .................................................

vi) Email Id.: .................................................

vii) Website, if any: ..................................................

2. Subject/s of which Evidences of Assessments are being sent {Please tick (✓)}

i) English ii) Hindi iii) Mathematics iv) Science v) Social Science	..... ..... ..... ..... .....

3.   Number of students in Class IX/X...................................................................................................................
4.   Number of Sections in Class IX/X....................................................................................................................
5.   Number of tasks in Class X (FA-1 and FA-2):

	FA-1	FA-2
i) English ii) Hindi iii) Mathematics iv) Science v) Social Science	..... ..... ..... ..... .....	..... ..... ..... ..... .....

6. Number of tasks in Class IX (FA-3 and FA-4):

	FA-3	FA-4
i) English ii) Hindi iii) Mathematics iv) Science v) Social Science	..... ..... ..... ..... .....	..... ..... ..... ..... .....

7. Criterion used in awarding final grades under Formative assessments

8. Type of tasks in FA-3 and FA-4 (Quiz, Book Review, Visit, Field Trip, Survey Project Work ( group/Individual), Models, Unit Test, Group Discussion, Debate, Declamation, Dramatization, Role play, Presentation, Seminar, Practicals, Maths Lab Activities, Listening and speaking skills, Map work, etc).

Use separate sheets for each of the formative assessments.The evidence sent must include the breakup of marks on different rubrics/parameters of each activity.

9. Formative Assessment Samples

Samples provided in case of three categories with names

	Names of students & Roll No. assigned by the Board	Total[1]	Total*	Marks	Types of
		Marks obtained in	Maximum marks in	obtained in Summative Assessment I	Samples enclosed[2]
		FA-1	FA-2	FA-1	FA-2
Top level of Achievement (Top 05 students)	1.
2.
3.
4.
5.
Middle level of Achievement (Mid 05 students)	1.
2.
3.
4.
5.
Bottom level of Achievement (Bottom 05 students)	1.
2.
3.
4.
5.

[1] This pertains to the Assessments of FA -1 and FA -2 which have been finally taken into account for arrivingat the grades. Samples of all assessments used for arriving at grades under FA -1 and FA - 2should be sent.

[2] There should be a variety of tasks / assessments and if samples are not possible, reports be attached.

9. Question Papers for Summative Assessment I (SA-1)

(i) Question Paper sent by CBSE

(ii) Question Paper Mixed and matched from papers sent by CBSE

(iii) Question Papers framed by the school

10. Summative Assessment Samples

Samples provided in case of three categories with names

	Names of	Marks	Answer script,	Marks
	students &	obtained in	supplementary	obtained in
	Roll No.	Summative	answer scripts,	Formative
	assigned by	Assessment	drawing sheet,	Assessment
	the Board		graph paper etc. enclosed
Top level of	1.
Achievement	2.
(Top 05 students)	3.
	4.
	5.
Middle level of	1.
Achievement	2.
(Mid 05 students)	3.
	4.
	5.
Bottom level of	1.
Achievement	2.
(Bottom 05	3.
students)	4.
	5.

11. Evidence of Assessment in Co-Scholastic

a) Report of Activities done (in one page to be attached)

b) Indicators of Assessment used (in one page to be attached)

List of Students who have been selected for the study of Evidence of Assessment

(Formative Assessment)

	Names		Grades Obtained in
	of
	students
	& Roll	Life	Work	Visual and	Attitudes	Co-	Type of evidence enclosed
	No. assigned	Skills	Education	Performing Arts	and Values	Curricular Activities
	by the
	Board
Top level of	1.
Achievement	2.
(Top 05	3.
students)	4.
	5.
Middle level	1.
of Achievement (Mid 05 students)	2.
3.
4.
5.
Bottom level of Achievement (Bottom 05 students)	1.
2.
3.
4.
5.

List of Students who have been selected for the study of Evidence of Assessment

(Summative Assessment)

	Names	Grades Obtained in
	of
	students
	& Roll	Life	Work	Visual and	Attitudes	Co-	Type of evidence enclosed
	No. assigned	Skills	Education	Performing Arts	and Values	Curricular Activities
	by the
	Board
Top level of	1.
Achievement	2.
(Top 05	3.
students)	4.
	5.
Middle level	1.
of	2.
Achievement	3.
(Mid 05	4.
students)	5.
Bottom level	1.
of	2.
Achievement	3.
(Bottom 05	4.
students)	5.

I certify that the information given is correct and has been personally verified.

Date: ............................................

SIGNATURE OF HEAD OF SCHOOL

NAME.....................................................

SEAL OF HEAD OF SCHOOL COMPLETE ADDRESS.............................................

ANNEXURE III

Attachments with the checklist (Please ✓ ):

1.	Samples of evidences of assessments for 15 students for FA-1 and FA-2 taken together
2.	Samples of evidences of assessments for 15 students for SA1 (Answer Scripts, Supplementary Answer Scripts, Drawing Sheets, Graph Paper etc.)
3.	Samples of Question Paper used for SA-1
4.	Samples of Marking Scheme used for SA-1
5.	Write-up on evidences of Formative Assessments that cannot be sent (if applicable)
6.	Write-up and samples on activities done under Co-scholastic areas
7.	Write-up on activities and indicators of assessment used for Co-scholastic Activities.
8.	Photocopy of the Attendance register highlighting the selected 30 candidates
9.	Copy of the Teachers' Diary
10.	Student portfolio/Observation Scale/ Anecdotal Records used for co- scholastic areas and Activities

Receipt of Delivery of Evidences of assessment to the Regional Officer/City Coordinator Received the above material from................................................................................................................................

Signature of the Regional Officer/City Coordinator Name and address

Dated:

Evidence of Assessments (EAs) : Checklist

CHECKLIST FOR COLLECTION OF STUDENT DATA - SBA - SCHOLASTIC

CLASS X: 2012-13

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