IEP 4 Services IEP 4 Services (Alt. year: )
Name
Date
Describe how student's disability affects involvement and progress in general curriculum (or for preschoolers, participation in appropriate activities)
Yes
No
Yes
No
(In selecting the LRE, consideration is given to any potential harmful effect on the child or the quality of services needed) (CFR: 300.522)
Service options considered:
Services
In order for the student to advance appropriately toward attaining annual goals, to be involved and progress in the general curriculum and to participate in extracurricular and other nonacademic activities:
Category
Supplementary Aids and Services
Personnel/Agency Responsible
Initiation Date
Duration
Frequency
Location
Services
Personnel/Agency Responsible
Start/End Date
Duration
Frequency
Location
Extended School Year (ESY):
Yes
No
Yes
No
Describe services:
Student will not participate in the general education environment for
because
Extent student will NOT participate in the general education classes and extra curricular activities
Will all special education services be provided at the student's school of residence?
Yes
No (rationale)
Yes
No (rationale)
Transportation
Transportation
Yes
No
Yes
No
Special Ed (specify)
General Ed
Special Ed (specify)
General Ed
Special Ed (specify)
General Ed
Special Ed (specify)
General Ed
Physical Education
None
None
General
General
Specially Designed (describe)
Specially Designed (describe)
NOTE: Pressing CANCEL does not undo changes to the lists (above).