Services
Name   IEP Date

Service options considered (in selecting LRE, consideration is given to any harmful effect on the child or quality of services that the child needs)

SUPPLEMENTARY AIDS AND SERVICES TO BE PROVIDED TO THE CHILD OR ON BEHALF OF THE CHILD And PROGRAM MODIFICATIONS OR SUPPORTS FOR SCHOOL PERSONNEL
  Aids, Services, Program Modifications, and/or Supports   Start/End Date Frequency Duration Location

SPECIAL EDUCATION and RELATED SERVICES
  ESY Services Ind/Grp Provider Start/End Date Frequency Duration Location
Yes No [DNR]  Grp Ind /wk

EXTENDED SCHOOL YEAR (ESY)  
Programs and services will be provided according to when student is in attendance and consistent with the public school calendar and scheduled services, excluding holidays, vacations, and non-instructional days unless otherwise specified.

NOTE: Pressing CANCEL does not undo changes to the lists (above).