Placement
Name   IEP Date

Physical Education   (if special, specify type)
 
District of Service School of Attendance School of Attendance
 
If you cannot find the school of attendance listed in the drop-down list, you can try entering the school code and/or name here:
 

School Type Federal Setting
 
Preschool Setting  
 

All special education services provided at the student's school of residence? All special education services provided at the student's school of residence?
% of time student is OUTSIDE the general education environment % of time student is OUTSIDE the general education environment
% of time student is IN the general education environment % of time student is IN the general education environment
 
Student will not participate in the general education environment for
because
 

Other Agency Services
Other agency services (specify):

 
  Student Eligible for Mental Health Services under Chapter 26.5?  
  Mental Health Services Language included on the IEP?  

Promotion Criteria  
 

Parents will be informed of progress  
 
How?  
 

 

Activities to Support Transition
(e.g. preschool to kindergarten, special education and/or NPS to general education class, 8th-9th grade)

Graduation Plan
(Grade 8 and Higher)
Projected graduation date and/or secondary completion date Projected graduation date and/or secondary completion date
 
Plan type   
 
Beginning no later than grade 9 parent(s)/guardian(s) and student has been informed that as of the 2006-2007 school year student must pass the California High School Exit Exam to earn a diploma.