IEP TEAM MEMBER EXCUSAL
From A Meeting In Whole Or In Part

  Incomplete Incomplete
 
 
  Student's Name ,
   
  Date of Meeting
   
 
By mutual agreement between the parent/adult student, and designated representative of the local education agency, the presence and participation of the Individual Education Program team member(s) identified below is/are not necessary and has/have been excused from being present and participating in the meeting scheduled on because (1) the member’s area of the curriculum or related services is not being modified or discussed in the meeting or (2) the meeting involves a modification to or discussion of the member’s area of curriculum or related services and the member submitted, in writing to the parent and the IEP team, input into the development of the IEP prior to the meeting.
 

 
Individual Education Program Team Member(s) Area Of Curriculum Or Related Services Check appropriate column explaining why the IEP team member is being mutually excused from the IEP meeting in whole or part:
Area Of Curriculum Or Related Services is Not Being Discussed or Modified Written input has been submitted to the parent and the IEP team prior to the meeting regarding the Area of Curriculum or Related Services.
 

 
By mutual agreement the IEP team members identified above, have been excused from being present and participating in my child’s IEP meeting.
 
CIRCLE relationship to student, sign, and date below.
 
Signature of Parent/Guardian/Surrogate:     Date:     
 
   
 
 
Signature of Parent/Guardian/Surrogate:     Date:     
 
   
 
 
Signature of Adult Student (ages 18-21):     Date:     
 
   
 
 
Signature of Designated District Representative:     Date:     
 
   
 
 
Title  
 
       
 

 
“IDEA Section 614 (d) (1) (c) IEP TEAM ATTENDANCE-
‘(i) ATTENDANCE NOT NECESSARY ­ A member of the IEP team shall not be required to attend an IEP meeting, in whole or in part, if the parent of a child with a disability and the local educational agency agree that the attendance of such a member is not necessary because the member’s area of the curriculum or related services is not being modified or discussed in the meeting, ‘(ii) EXCUSAL- A member of the IEP Team may be excused from attending an IEP meeting, in whole or in part, when the meeting involves a modification to or discussion of the member’s area of curriculum or related services, if—‘(I) the parent and the local educational agency consent to the excusal; and ‘(II) the member submits, in writing to the parent and the IEP team, input into the development of the IEP prior to the meeting. ‘(iii) WRITTEN AGREEMENT AND CONSENT REQUIRED- A parent’s agreement under clause (i) and consent under clause (ii) shall be in writing.”