Services
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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, 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
 

 
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).