Suspension Beyond Cumulative School Days in a School Year

 
 
Date Date Pick a date
 
Student   DOB
 

 
Current Code of Conduct violation
 
Number of proposed suspension days for this offense
 
Total cumulative suspension days this school year (including current suspension)
 
  Extent of services necessary during suspension to enable student to continue to appropriately progress in general curriculum and appropriately advance toward the goals in the IEP:  
 
 
 

 
DETERMINATION OF EXTENT OF SERVICE NEEDS
 
1. School personnel under authority to remove (for not more than 5 school days at a time) determining extent of services to occur during suspension:
  title
 
2. Special education teacher also involved in determining extent of services to occur during suspension:
 
 

 
SUSPENSION HISTORY REVIEW
 
In considering this suspension, school personnel,   title  reviewed the proposed suspension and history of suspensions and determined this suspension does not constitute a pattern of suspensions equivalent to a change in placement. The following factors were considered:
 
  length of removal of current suspension
  total amount of time the student has been removed this school year
  proximity of removals
 

 
Scheduled IEP date Scheduled IEP date Pick a date
 
(Scheduled < 5 business days from this removal)
 
  to to develop a functional behavior assessment, or develop a functional behavior assessment, or
  to review existing behavior support plan contents, implementation of existing plan and potential modifications of plan