Master Agreement 2005 - State Employment Relations Board

IEP Forms
]IEP Individualized Education Program
.NONACADEMIC AND EXTRACURRICULAR ACTIVITIES
In what ways will the child h~ve the opportLmity to participate in nonacademic/.,xtr;,curricua...r activities with his/h"r nondisabl"d peers?
lfthe childwillnotparticipateinnon-aca demiC/.,xtracurricularactivities,explain.
(I) GENERAL FACTORS
HAS THE IEP TEAM CONSIDERED;
Thestrengthsofthechild?
The concerns of the parents for the education of the child?
Theresultsoftheinitialormostrecentevaluationsofthechild?
As appropriate, the results of performance on any state or district-wide assessments?
The academic. developmental, and functional needs of the child?
The need for extended school year (ESY) services
DThe team has determine d that ESY services are not neces.ary
YESO
YES0
YES0
YESO
YESO
NOD
NOD
NOD
NOD
NOD
0The team has determine d that ESY services are necessary for the following
GoalsandObjectivesorBenchmarks: -----------------
0The team nee ds to collect further data before making a determination and
willmeetagainby·
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]IEP Individualized Education Program
41) LEAST RESTRICTIVE ENVIRONMENT
Does this child attend the school (or for a preschool-age child. P"-rticipate in the environment
he/shewouldattend)ifnotdisabled?
lfnojustify(justificationmaynotbe>oi