Signature and Parent Consent (6B)
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Name
IEP Date
IEP Meeting Participants
Parent
Date
Parent
Date
LEA Representative/Admin. Designee
Date
General Education Teacher
Date
Student
Date
Special Education Specialist
Date
Additional Participant/Title
Date
Additional Participant/Title
Date
Additional Participant/Title
Date
Additional Participant/Title
Date
Additional Participant/Title
Date
Additional Participant/Title
Date
Parent Consent
____
I agree to all parts of the IEP
____ I agree with the IEP, with the exception of
____
I understand that my child is NOT eligible for special education.
____
I understand that my child is NO LONGER eligible for special education.
Signature below is to authorize and approve the IEP.
Signature:
Date:
Relation
(if other, specify:)
Signature:
Date:
Relation
(if other, specify:)
Did the school district facilitate parent involvement as a means of improving services and results for your child? Yes ___ No ___
Student enrolled in private school by their parents. Refer to Individual Service Plan, if appropriate.