Services (5A)
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Name   IEP Date
 

 
  Service options that were considered by the IEP team (list all) Service options that were considered by the IEP team (list all) Service options that were considered by the IEP team (list all)  
 
  (in selecting LRE, describe the consideration given to any potential harmful effect on the child or quality of services that the child needs)  
 
 
 Espaņol  (...)
 
 

 
SUPPLEMENTARY AIDS, SERVICES & OTHER SUPPORTS FOR SCHOOL PERSONNEL, OR FOR STUDENT, OR ON BEHALF OF THE STUDENT SUPPLEMENTARY AIDS, SERVICES & OTHER SUPPORTS FOR SCHOOL PERSONNEL, OR FOR STUDENT, OR ON BEHALF OF THE STUDENT SUPPLEMENTARY AIDS, SERVICES & OTHER SUPPORTS FOR SCHOOL PERSONNEL, OR FOR STUDENT, OR ON BEHALF OF THE STUDENT
  Aids, Services, Program Accommodations/Modifications, and/or Supports   Start/End Date Frequency Duration Location
 

 
    Transportation Transportation Transportation  type:  (describe if special ed:) 
 

 
  Note regarding the 2012-2013 (and later) printed forms and transportation:

These printed forms indicate only whether special education transportation is provided. General education transportation is not shown. For the current printed form only (but not for previous printed forms):

1. If the transportation box here is not checked, and nothing is selected as the type, then neither "Yes" nor "No" will be checked on the printed form.

2. If the transportation box here is not checked, and you select "None" as the type, then neither "Yes" nor "No" will be checked on the printed form.

3. If the transportation box here is checked, and (1) there is no type; or (2) there is a type other than "Special ed", then the "No" box will be checked on the printed form.

4. Whether or not the transportation box is checked, if you select "Special ed", as the type, then the "Yes" box will be checked on the printed form. Note that for special ed you must also enter a description under "(describe if special ed:)".
 

 
SPECIAL EDUCATION and RELATED SERVICES SPECIAL EDUCATION and RELATED SERVICES SPECIAL EDUCATION and RELATED SERVICES
 
NOTE: No dropped services will appear in this list.
 
NOTE: Only current services and services dropped on/after will appear in this list.
 
  ESY Services Ind/Grp Provider Start/End Date Frequency Duration Location
Yes No [DNR]  Grp Ind ST /wk -
 

 
EXTENDED SCHOOL YEAR (ESY)  
Programs and services will be provided according to where student is in attendance and consistent with the district of service calendar and scheduled services, excluding holidays, staff development days, vacations, and non-instructional days unless otherwise specified.
 
 
NOTE: Pressing CANCEL does not undo changes to the lists (above).