Graduation Verification Template for Students Not Meeting
Assessment Graduation Requirements for SY 2020-2021
This form is to be completed once a student has completed the minimum 20 learning hours for the subject pair(s) not
passed and has demonstrated knowledge equivalent to Approaching Basic on their high school assessment(s).
Guidance
1. Fill in the fields below and answer the accompanying questions.
2. Obtain the required signatures.
3. Save the document using the following file naming convention:
6-DigitSiteCode_StudentLocalIDNumber_SchoolSystemValidationofGraduatio
i. (ex: 001001_123456789_SchoolSystemValidationofGraduation)
4. Upload the form and supporting documents to the eScholar FTP Credentials Folder
* Please contact your school system’s data manager who can assist in uploading these forms and documents for your system.
School System Verification of Meeting High School Assessment Requirements for School Year 2020-2021
Student Name
Louisiana Secure
ID (LASID)
School Name
School System
Name
Subject Pair Not Passed
Check all that apply
English
Math
Science/Social Studies
Which of the following tools were used to assess the
student:
Check all that apply
Review of student portfolio of work
Teacher-created assessment
School System-created assessment
Other Assessment (please describe)
Other (please describe)
Statement of Completion:
By signing below, I verify that this student has completed the minimum 20 learning hours for the subject
pair(s) not passed and that this student has demonstrated knowledge equivalent to Approaching Basic on
their high school assessment.
Teacher Name
Date
Principal Name
Date
click to sign
signature
click to edit
click to sign
signature
click to edit