Individualized Education Program

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IEP Date   Student Name

PLACEMENT RATIONALE / REASON FOR DECISION
Considered       Rationale

   
   
   
   
   
Other: Other:
   
 
Tests, evaluation, information relied upon:
     
 
 
 

GENERAL EDUCATION PARTICIPATION
Academic Subjects:  
 
Electives:  
 
 
 
Other:
 
General Education Accommodation/Modifications
 
Provision for Transition to General Education
 
BEHAVIOR:
Student's behavior   impede learning of self or others (describe)
 
PARENT COMMUNICATION/REPORTING SCHEDULE:
   Report Cards - Concurrent with issuance of General Education Report Cards
 
   Home/School Communication:
 
   Other: