Blank Transition Iep (For Students 14 And Older) (Page 11 of 13) in pdf

Blank Transition Iep (For Students 14 And Older) Page 11

Student:

STN:

DOB:

Age:

Grade:

Gender:

Progress Reporting:

Please describe when periodic reports on the progress the student is making toward meeting the annual goals will be

provided:

Least Restrictive Environment and Program:

School of Legal Settlement: _____________________________________________________

School of Service: _____________________________________________________________

Additional information regarding school of service:

(For Transition IEPs) Course of Study focused on improving academic and functional achievement of the student in

order to support the attainment of post-secondary goals:

LRE Placement Category based Federal Program Types:

School Age (6-21) - Student will be Age 6+ as of next December 1st

Regular class 80% or more (In a regular classroom for 80% or more of the day)

Resource Room (In a regular class for 40% to 79% of the day)

Separate Class (In a regular class for less than 40% of the day)

Separate day school facility

Residential Facility

Correctional Facility

Parentally placed in private school

Homebound/hospital

Preschool Age (3-5) - Student will not be 6+ as of the next December 1st

Regular Early Childhood class 80% of the time

Regular Early Childhood 40-79% of the time

Regular Early Childhood 40% or less of the time

Separate Class

Separate School

Residential Facility

Service Provider Location

Home

Additional Descriptors:

Any potentially harmful effects of the services on the student or on the quality of services needed:

Reasons for placement determination including reasons for rejecting other options:

Page 11 of 13

Blank Transition Iep (For Students 14 And Older) Page 11