Dear
Jose and Luisa
We would like to meet with you to discuss the educational needs of your child:
Toby
at .
Viterbo University
The purpose(s) of this IEP team meeting is to (check all that apply):
Transfer IEP
Review/Revise/Update IEP:
Develop a statement of transition (post-secondary) goals and services, required for child 14 and older
or younger if appropriate. If transition planning is being considered we must invite your child to the
meeting. If applicable, we must invite a representative of any participating agency that is likely to be
responsible for providing or paying for transition services.
N/A
If at any point during this meeting you or other IEP team participants believe that additional time is
needed to permit your meaningful involvement, additional time will be provided. Decisions related to the
purpose(s) checked above may be made in one meeting or may require more than one meeting depending
on individual circumstances. You are a participant of the team and encouraged to attend this meeting,
which must be at a mutually agreeable time and place. You may bring a friend or advisor who, you believe,
has knowledge or special expertise about your child to the meeting with you if you wish. If your child is
transferring from a Birth to 3 Early Intervention Program we will, at your request, send to the Birth to 3
coordinator or other representative an invitation to the IEP meeting. If a purpose of this meeting is to
determine eligibility for special education, an IEP will be developed only if your child is determined to be
eligible for special education. Upon request, you may receive a copy of the IEP teams most recent
evaluation report at any meeting of the IEP team.
The following individuals have been appointed as IEP participants and will attend the meeting:
Role Name/Title
General Education Teacher Mrs. McDonald
Special Education Teacher/LD Mrs. Ridge
LEA Representative/Direct of Special Education Sally Smith
School Psychologist Mr. Zambie
The following individuals have been invited as IEP participants who may attend the meeting, but are not
required participants:
Role Name/Title
Principal Chris Mastree
Other options related to the scheduling, participants, or purpose of the meeting considered, reason(s)
these options were rejected, and other relevant factors:
You and your child have protection under the procedural safeguards (rights) of special education law. The
school district must provide you with a copy of your procedural safeguards once a year and when the
school is seeking a disciplinary change in placement and/or when responding to a request for due process
hearing or IDEA complaint. Previously you received a copy of your procedural safeguards rights in a
brochure about Special Education Rights for Parents and Children. If you would like another copy of this
brochure, please contact the school district at the telephone number below. In addition to the district staff,
you may also contact the organizations listed on the Special Education Rights for Parents and Children
brochure if you have questions about your rights.
A copy of your procedural safeguards rights is provided with this form in a brochure about Special
Education Rights for Parents and Children.
Initials Date
AZ 12/4/2016
If you have any questions about this meeting or understanding your rights, I can be reached at
123-456-7890
Contact Title
Special Education Teacher
Address
123 Oak St
City
LaCrosse
State
WI
Zip
12345
Email
abc123@gmail.com
(date) , at .
12/8/2016 Viterbo
(date), at .
Parent, please check the appropriate box, sign, date, and return this page to the District Contact
Person.
Date Signed:
12/2/2016
Initials
AB
Parent/Guardian 1
Parent/Guardian 2
Full Name Street Address City State Zip Code Phone(s)
Jose 123 Oak St LaCrosse WI 12345 987-654-6544
Meeting Date
12/8/2016
Title
Transfer IEP
Review/Revise/Update IEP:
Develop a statement of transition (post-secondary) goals and services, required for child 14 and older
or younger if appropriate.
If a purpose of this meeting is IEP development, review, and/or revision, related to the academic,
developmental and functional needs of the child, the IEP team considered the results of the initial or most
recent evaluation and results of statewide or district wide assessments.
Yes N/A
Did the parent(s)/adult student attend or did they participate in the meeting by other means?
Yes No
If parent(s)/adult student did not attend or did not participate in the meeting by other means document 3
good faith efforts to involve parent(s)/adult student:
Date Method and Input
Beinborn/Special Education
Phone
123-456-7890
Email
abc123@gmail.com
Meeting Date
12/8/2016
If yes, list positive behavioral interventions, strategies, and supports to address that behavior
(document needed services in the Instructional Services)
If yes, describe how this factor affects the child's needs related to the IEP.
C. Does the child have communication needs that could impede his or her learning?
Yes No
If yes, identify the communication needs including (a) the child's language; (b) opportunities for
direct communication with peers and professional personnel in the child's language and
communication mode; and, (c) academic level and full range of needs including opportunities for
direct instruction in the child's language and communicative mode.
D. Does the child need assistive technology services or devices, including any services or devices
needed to assist with reading?
Yes No
If yes, specify characteristics of device(s) or services that were considered (document needed
services in the Instructional Services).
If yes, identify the communication needs including (a) the child's language; (b) opportunities for
direct communication with peers and professional personnel in the child's language and
communication mode; and, (c) academic level and full range of needs including opportunities for
direct instruction in the child's language and communicative mode.
F. If visually impaired, does the child demonstrate a current or future need for Braille instruction or the
use of Braille? In making your determination, consider reading skills, written language skills and future
needs for Braille skills.
Yes No N/A
H. Is the child aged 14 or older, or will the child turn age 14 during the timeframe of this IEP?
Yes No
Meeting Date
12/8/2016
III. Assessment
A. Participation in General Education Curriculum
The child participates full-time in general education curriculum aligned with the general education
standards that apply to all children, or for preschoolers, in age-appropriate activities aligned with
Wisconsin Model Early Learning Standards (WMELS).
The child participates in curriculum aligned with alternate achievement standards. See Participation
Guidelines for Alternate Assessment Form I-3-S7
B. Statewide Assessments
1. The Wisconsin Forward Exam:
In this IEP year, is the child or will the child be in grade 3-8 or 10 and taking the Wisconsin Forward
Exam during the time the assessment is given?
(Students in grades 3-8 will participate in English language arts (ELA) and mathematics. Science is
administered in grades 4 and 8. Social Studies is administered in grades 4, 8, and 10.)
Yes No
Yes No
viewing.
Measuring Tools [Math Tools] This tool set includes both standard and metric
rulers that can be dragged to the desired location on
the screen and pivoted, to take measurements in
both inches and centimeters. Also included is a
transparent Protractor for measuring angles that can
be moved over any object on the screen and
rotated.
Pause [Breaks] Students may be allowed to take breaks periodically
as determined by their test administrator. While
away from the test, students should select the Pause
button in the lower toolbar to ensure that their test
questions and responses are not visible to others.
Insight permits students to pause the test for up to
20 minutes without having to log
back in to the current test session. A countdown
timer is displayed to indicate the amount of time
remaining. In the event that the student
does not resume testing before the 20 minute time
expires, the system automatically exits the students
test session. To resume testing, the student will
need to re-enter the username and password
provided on the test ticket.
Review Page Selecting the Review/End Test button in the lower
toolbar allows student to see at a glance which items
have been answered or flagged and which remain
unanswered. By clicking on a particular item, the
student can return directly to incomplete or flagged
questions, and/or to change answers. This page
indicates to the student if a test is ready
to be scored.
Sticky Notes [Digital Notepad] Creates and places a note on the screen in which a
student can type a short message for later
reference. Multiple notes can be created for each
item or passage, and the notes can be moved
around the screen, minimized or completely hidden,
and re-opened. For a passage or scenario that
contains multiple parts (for example, one passage
that has several questions associated with it), the
student can use the Sticky Note tool to take notes
that are visible for all questions associated with that
passage or scenario.
Test Directions Easy-to-follow instructions are provided at the
beginning of the test to guide students on how to
use the online tools and how to navigate and submit
the test. Students can return to them at any point
during the test by selecting the Help menu in the
item page toolbar.
students needs.
Masking Allows the student to cover up Students with attention
(mask) content that may be difficulties, print disabilities, or
distracting, enabling the visual impairments may need to
student to more easily focus mask content that may be
their attention on a specific part distracting during the
of the screen. Masked areas are assessment.
resizeable and moveable on the
item page.
Text-to-Speech The Text-to-Speech (TTS) Text-To-Speech (TTS) is allowed
function allows the student to as an embedded designated
listen via headphones or support for all grades in
speakers to test information Mathematics, Science, Social
displayed on the screen. Words Studies, and English Language
and numbers, including test Arts (ELA) items as appropriate
directions, questions, answer (not ELA reading passages). It
choices, and other information is provided only in English. The
is read aloud and can be designated support of TTS is for
repeated as necessary. students who are struggling
readers who may need
assistance accessing the
assessment or students with
reading-related disabilities, or
by students who are blind and
do not yet have adequate
Braille skills. This is not meant
to be used by all students. TTS
is not a universal tool. Allowing
TTS, a designated support, for
all students would not be a
proper use of this support.
Stacked Translations are For students whose primary
Translations (Stac ked)
available as a language support language is not English and
to designated students on all who use dual language
Math, Science, and Social supports in the classroom, the
Studies assessments. For ELA use of the translation
assessments, only the test accommodation may be
directions are available in appropriate.
stacked translation. Stacked
Translations present students
with a complete translation
(Spanish) of all test content
together with the full text of
the original English.
Non-embedded Designated Supports
Designated Supports Description Guidance
Bilingual Dictionary A word-to-word bilingual Not permitted on ELA tests.
dictionary may be provided as a Refer to the DPI
Video Sign Language (VSL Signed test content is Some students who are deaf or
online delivery for American presented in an embedded hard of hearing and who
Sign Language (ASL)) video format by a prerecorded typically use ASL may need this
human signer. Students accommodation when accessing
activate the presentation of ASL text-based content in the
content by selecting start assessment.
points on the test page and can
view as often as needed using
the embedded video player
controls. ASL content will be
available to students with this
accommodation for ELA
listening items and for all Math,
Science and Social Studies
content.
All American Sign Language Students who are deaf or hard
Closed Captioning (for ELA
videos for ELA Listening items of hearing who typically access
Listening items)
will include Closed Captioning information presented via audio
(text transcription) as part of by reading words that appear in
the video presentation. Other synchrony with the audio.
ASL content will not include
Closed Captioning
Text-to-Speech (TTS) Text-to-speech playback will be This accommodation refers to a
available to students with this small number of students
accommodation for all test (approximately 1-2% of
content, including for ELA students with disabilities
Reading passages. (See Text- participating in a general
to-Speech in Embedded assessment). Text-to-speech is
Designated Supports) available as an accommodation
for students whose need is
documented in an IEP or 504
plan. Reports can be run to
indicate the percent of students
who had access to text-
tospeech on reading test
passages. Students who use
text-to-speech will need
headphones unless tested
individually in a separate
setting.
Non-embedded Accommodations
Accommodations Description Guidance
Abacus This tool may be used in place Some students with visual
of scratch paper for students impairments use an abacus in
who typically use an abacus. place of using scratch paper.
Alternate Response Options Alternate response options Some students with physical
include but are not limited to disabilities may need to use the
adapted keyboards, large alternate response options
`
Yes No
I-3-S7 Participation Guidelines for Alternate Assessment must be included with IEP.
Color Contrast
Read Aloud with highlighting Text to Speech (TTS) - Text & Graphics
Uncontracted Braille
Two-switch system
Individualized Manipulatives
Supports Provided Outside the DLM System
Human Read Aloud
Meeting Date
12/8/2016
III. Assessment
B. Statewide Assessments (continued)
3. ACT Aspire Early High School:
In this IEP year, is the child or will the child be in grade 9, 10 and taking the ACT Aspire during the
time assessment is given?
Yes No
Embedded Features are available to all students for computer administered ACT Aspire
Early High School Assessments. No advanced request or documentation is needed.
Embedded features include: QWERTY keyboard, mouse, copy and paste functions, font
size, magnifier tool, highlighting, calculator, mark item for review, scratch paper, browser
zoom, magnification.
Open Access Tools are also available for any student for whom the need has been
indicated, but must be activated through the Personal Needs Profile (PNP) in advance of
the assessment.
Accommodations must be entered into the Personal Needs Profile, in advance of the
assessment. Disability related documentation is not submitted for the ACT Aspire Early
High School.
Accessibility Feature Content Areas
Presentation Supports Support Reading English Writing Math Science
Level
Presentation supports allow an examinee to receive the information intended by the test design in a way that honors and
upholds the rigor of the construct being tested while meeting the individual needs of the examinee. ("Dir. Only" is an
abbreviation for Directions Only)
Text to Speech (English Audio) Accommodati Dir. Only Dir. Only
on
Orienting Description) on
Only on
Only on
300 400
Locally Approved Accommodations and Supports Students Testing with Standard Time do
not require review or prior approval from ACT; however, a test irregularity report must be
submitted to ACT
ACT-Approved Accommodations
Result in scores that are fully reportable to colleges, scholarships, and other entities.
Required Documentation for ACT-Approved Accommodations
State-Allowed Accommodations
Result in scores that are not college reportable; they are used for state accountability
purposes.
If accommodations are not approved by ACT and State Allowed accommodations are
utilized the Wisconsin State-Allowed Accommodations Notification form must be signed
acknowledging that scores earned through the use of State-Allowed Accommodations on
the ACT Plus Writing are not college reportable. Similarly, scores earned through the use
of State-Allowed Accommodations on the ACT WorkKeys are not eligible for National
Career Readiness Certification (NCRC).
- Locally Approved Accommodations and Supports Students Testing with Standard Time
(Do not need review or prior approval)
Locally Approved Accommodations and Supports Students Testing with Standard Time
(Do not need review or prior approval)
Designated Support Description
Administration of the Appropriate off-site or home-bound application must be
assessment in an approved by ACT.
alternate education
setting (out of school)
July 1, 2015 2015 CESA 6 I-1 -
Invitation to IEP Meeting
Chelsea Beinborn
with appropriate
supervision e.g.,
Home when student is
homebound,
Care facility when it is
medically necessary,
Juvenile facility
Administration of the If setting is off-site, appropriate off-site application must be
assessment individually approved by ACT.
or in a small group
The use of preferential
seating (e.g., front of
the room, back of the
room)
Use of accommodated
seating, special lighting,
or furniture
Able to move, stand or Student must test individually.
pace during
assessment
in a manner where
others work cannot be
seen and is not
distracting to others
(e.g.,
kneeling, constant
movement).
Student reads aloud to Student must test individually
him or herself
Use of sound Provided by school or student; student must test
amplification system individually if device causes distraction
for test directions only
Directions provided Applies only to spoken instructions exactly as provided in
using sign language the administration manual. ASL for test items is not ACT
American Sign Approved
Language (ASL) or
Exact English Signing
(EES)
Qualified person All directions for test administration are read verbatim in
familiar to the student English with no clarifications in another language.
administers the Qualified person cannot be a relative and must meet the
assessment (e.g., same ACT requirements as all testing staff
Special
Education Teacher,
Bilingual/ESL staff)
ACT Approved Timing and Scheduling Accommodations
(Submit application for ACT approved accommodations)
July 1, 2015 2015 CESA 6 I-1 -
Invitation to IEP Meeting
Chelsea Beinborn
Specialized, or
trackballs or mice
Use of a scribe for Applies only to ACT Writing Test. Only if tested individually.
constructed response Refer to manual for scribe policies.
items
(student must indicate
punctuation, format
and spell all keywords)
for Writing
Use of adapted paper, Provided by school. Student must test individually and
additional paper, lined responses transferred to scannable answer document by
or grid paper for testing staff while examinee observes. All materials must
recording answers be returned to ACT.
Use of Requests considered individually based on documentation
augmentative/alternati submitted. Approval and reportable status depend on
ve detailed information about the devices proposed for use.
communication
devices, e.g.,
Picture/symbol
communication boards,
Speech generating
devices
Meeting Date
12/8/2016
III. Assessment
B. Statewide Assessments (continued)
5. Wisconsin Statewide Language Assessment:
According to Title III of the No Child Left Behind Act of 2001 section 3113 (b)(3)(D) all Limited
English Proficient/English Learner (LEP/EL) students are required to take annually a language
assessment in all four language domains of reading, writing, speaking and listening regardless of
disability status. Individualized Education Program (IEP) teams are required to decide annually
whether students who are classified as LEP/EL and who have a disability will participate in (1) the
ACCESS for ELLs with or without accommodations, or (2) the Alternate ACCESS for ELLs with or
without accommodations.
1- In this IEP year, is the child classified as an English Learner (ELP 1-5) and will be in grade
K,1,2,3,4,5,6,7,8,9,10,11 or 12 during the time the assessment is given?
Yes No
C. District-Wide Assessments
1 Early Literacy Screener
In this IEP year, will the child be in 4K, Kindergarten, First or Second grade?
Yes No
Accommodations Necessary?
Yes No
Accommodations Necessary?
Yes No
1 If yes, list the name of the assessment(s) and necessary accommodations, if any.
Toby will be assessed by taking the following assessments: STAR, MAPS, and DIBELS.
Accommodations may include testing in a small group with minimal distractions, extending
time provided to complete the exam, and having tests and/or directions read aloud, if
allowed.
2) If no, document why the child cannot participate in the general district-wide assessment and
why an alternate assessment is appropriate.
Meeting Date
12/8/2016
A. State the strengths of the child (including academic skills, communication skills, social skills, and
interests):
Toby is very active and excels at any physical activity including P.E.. In the classroom, Toby loves to be a
helper and favors being a door holder. He excels at sharing with his peers and not creating conflicts over
objects. Toby enjoys all his special classes such as art, music, and P.E.. He enjoys drawing and singing
about animals, especially dinosaurs. Toby prefers hands-on in class activities and his favorite academic
subject is science. In the home, both parents state that Toby enjoys technology and is allowed to watch TV,
play video games, or on a tablet for one hour after school. Tobys mother states that she has seen a drastic
July 1, 2015 2015 CESA 6 I-1 -
Invitation to IEP Meeting
Chelsea Beinborn
improvement this year in his behaviors and they are not of concern in the home setting. Tobys father stated
that he has taken Toby to a dinosaur museum over the summer and now has sparked a huge interest in
science. Both parents believe Toby has close friends and his social relationships are appropriate.
B. Family Engagement
1 State the concerns of the parents/family for enhancing the education of the student. This may
include concerns about reading achievement, early language/communication or early literacy
skills, other academic areas, social-emotional needs, sensory needs, behavior, the child's future
and postsecondary transition, etc.:
Tobys mother has been concerned that Tobys previous childhood behaviors have interfered with him
being academically where he needs to be with his peers. She noted that language arts is her biggest
concern and the subject he is most behind in. Both parents are concerned about third grade being a
challenging academic year. Tobys parents both stated that his behaviors are 100% improved in the last
two years of school. He is now able to control his fidgeting and hyperactivity in an appropriate and
non-distracting way. Parents believe this is due to finding the correct medication regimen.
2 Describe the concerns (if any) of the student for enhancing his or her education:
N/A
3 How will school staff engage parents/families in the education of the student (e.g. sharing
resources, communicating with parents/families, building upon family strengths, connecting
parents/families to learning activities, etc.)?
Tobys team send frequent communication to Tobys father and mother regarding academics and
behaviors for both positive and concerns. Communication is and has been made through phone
calls, emails, and notes home. Toby also receives a weekly class newsletter along with a
classroom website. Tobys family is excellent at relaying information with home behaviors,
academic struggles or successes, and other concerns. There is a great communication line for
Toby between home and school.
Before developing annual goals, review the previous IEP goals and progress (document review on
previous IEP in IEP Team Review sections).
continued to show areas of concern after the interventions such as phonic analysis, structural analysis,
comprehension, r-controlled sounds, diphthongs, word endings, and silent consonants. Testing scores
for Toby provided the raw data for his reading concerns. Toby was assessed by the school psychologist
using the Wechsler Intelligence Scale for Children (WISC-R) which provides a score that represents a
child's general intellectual ability, Wide Range Achievement Test (WRAT) which measures an
individual's ability to read words, comprehend sentences, spell, and compute solutions to math
problems, and Broad Reading and Broad Written Language subtests of the Woodcock-Johnson
Psychoeducational Battery (WJPB) which allows for a considerably detailed analysis of cognitive
abilities. Testing scores were as follows:
WISC-R:
Verbal IQ = 108
Performance IQ = 128
Full Scale IQ = 119
WRAT Scores:
Reading Standard Score = 77/grade equivalent score = 1.6
Spelling standard score = 67/grade equivalent score = 1.8
Arithmetic standard score = 90/grade equivalent score = 3.1
WJPB:
Broad reading standard score = 94/percentile rank = 34
Broad mathematics standard score = 112/percentile rank = 78
Broad written language standard score = 86/percentile rank = 17
Broad knowledge standard score = 104/percentile rank = 61
Tobys general classroom teacher administered the Silvaroli Classroom Reading Inventory and results
indicated that Tobys independent reading level (reading comprehension) was at the second grade level,
his instructional reading level (reading comprehension) was at the second grade level, and his listening
comprehension was at the fourth grade level.
2. Describe the student's present level of functional performance (including impact on reading
achievement and access to instruction). For preschool children, describe the child's positive social-
emotional skills (including social relationships) and use of appropriate behaviors to meet their needs
and the impact on early literacy.
Tobys behaviors have greatly increased in appropriateness in the last two years. Neither Tobys
parents or teachers have any behavior concerns at this time. Toby is able to control his fidgeting in an
appropriate and non-distracting manner; he is allowed two fidgets in his desk. Toby can independently
locate various areas of importance in the school as his regular and special education classrooms, locker,
office, cafeteria and restrooms. Toby is clear and concise in when communicating. Toby enjoys
working with his peers in small groups for math class. He becomes disengaged at times during whole
July 1, 2015 2015 CESA 6 I-1 -
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Chelsea Beinborn
group reading, but his team is aware of his reading weakness and this is the priority area to work on.
E. Effects of disability
1 Does the student's disability adversely affect his or her progress toward meeting grade-level
reading standards? For preschoolers, does the disability adversely affect progress toward the
Wisconsin Model Early Learning Standards (WMELS) for language development,
communication and/or early literacy?
Yes No
2 Describe how the student's disability affects his or her access, involvement and progress in the
general education curriculum, including how the disability affects reading. For preschool
children, describe how the disability affects participation in age-appropriate activities, including
language development, communication and/or early literacy.
Tobys reading concerns impairs his ability in reading fluently due to his inability to use phonic
analysis, word endings, and silent consonants which greatly impacts his involvement and
progress in the general education curriculum.
Meeting Date
12/8/2016
Goal Number 1
Goal Title:
Reading
Baseline (Student's current level of performance from which progress toward this goal will be
measured)
Toby is curently at a begining year second grade instructional reading level and an end-of-y
Level of Attainment (Must relate to the baseline measurement and reflect progress)
Mid-year, third grade instructional reading level and end-of-year second grade indepenede
Procedure for measuring the student's progress toward meeting the annual goal from baseline to level
of attainment
Hudson Education Skills Inventory Reading (HESI-R)
B. PROCEDURES AND TIMELINE FOR NOTIFYING PARENTS OF CHILD'S PROGRESS TOWARD THE
ANNUAL GOAL
Progress Monitoring
Goal Objective
Frequency:
Bi-weekly
(Date) Yes No
Initials
Choose an item.
(Date) Yes No
Initials
Choose an item.
(Date) Yes No
Initials
Choose an item.
OR
Frequency:
Method:
C. SHORT TERM OBJECTIVES/BENCHMARKS necessary to describe the steps the child will take to make
progress in the general curriculum and reach the annual goal and disability-related educational needs:
Toby will work on skills in using beginning and ending consonants, vowel patterns and blends to
predict unknown words, read aloud accurately (90% to 100%) material from the grade level
sample reading list, and read using a balance of phonetic, semantic, and syntactic cues.
N/A
Meeting Date
12/8/2016
V. INSTRUCTIONAL SERVICES
A Statement for each of the following with amount, frequency, location, and duration.
SPECIAL EDUCATION
Special Education/ Amount Frequency Location Duration Related
Specially Designed Goal
Instruction
Reading RTI 45 minutes Daily Elementary School Length Reading
of IEP
Physical Education
Regular
N/A
Related Services
Yes
Audiological"
Counseling Services
Including
Rehabilitation
Counseling
Educational
Interpreting
Medical Services
(diagnostic or
evaluation)
Occupational Therapy
Orientation and
Mobility Services
(vision only)
Other Related
Services
Physical Therapy
Psychological
Services
Recreation
School Health
Services
School Social Work
Speech and
Language
Transportation
Aids, services, and other supports provided to or on behalf of the child in regular education or other
educational settings by regular education and/or special education staff.
N/A
Meeting Date
12/8/2016
School District.
Viterbo
2. Date parents/adult child was provided with this written notice of placement
12/9/2016
B. Will the child attend the school s/he would attend if non-disabled?
Yes No
If no, explain:
C.
You previously received a copy of the evaluation report, and a copy of the IEP is enclosed or
attached.
Copies of the evaluation report and the IEP are enclosed or attached.
D. List other options considered, if any, related to the placement site (school building or school
district), frequency, location, and the duration of the special education and related services,
supplementary aids and services, program modifications and supports, and the place of those
services. List the reason(s) rejected, and the description of any other factors relevant to the proposed
action:
N/A
Parent: You and your child have protection under the procedural safeguards (rights) of special education law. The school district must
provide you with a copy of your procedural safeguards once a year. Previously you received a copy of your procedural safeguard
rights in a brochure about Special Education Rights for Parents and Children. If you would like another copy of this brochure, please
contact the school district at the telephone number below. In addition to the district staff, you may also contact the organizations
listed on the Special Education Rights for Parents and Children brochure if you have questions about your rights.
Phone
456-456-6445
Email
abc123@gmail.com