Iep Revision Form - South Bend Community School Corporation Special Education Department Page 11
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13South Bend Community School Corporation
Special Education Department
IEP Revision
Student: ______________________________ STN: ______________________ Revise IEP of ____________________
Effective Dates:
Begin date: _____________________________ End date: __________________________________
General Considerations
Please consider the student's participation in general education and record any supplementary aids and services that are
determined by the case conference committee to be appropriate and necessary in order to afford the student equal
opportunity for participation with non-disabled students.
Student will be able to participate in all educational programs and activities available to non-disabled students.
___ Yes ___No
(If No, please state the exceptions and describe the reasoning for these exceptions:
Student will be able to participate in all non-educational and extracurricular activities available to non-disabled
students.
___ Yes ___No
(If No, please state the exceptions and describe the reasoning for these exceptions:
Student will participate in the general physical education program available to non-disabled students.
___ Yes ___No
(If No, please state the exceptions and describe the reasoning for these exceptions:
Student will be educated in the school he or she would attend if not disabled.
___ Yes ___No
(If No, please state the exceptions and describe the reasoning for these exceptions:
The length of the instructional day will be the same as the instructional day for non-disabled peers.
___ Yes ___No
(If No, please state the exceptions and describe the reasoning for these exceptions:
Participants
The following individuals participated in the case conference committee meeting. Those individuals identified as Teacher
of Record, General Education Teacher, Public Agency Rep and Instructional Strategist attended the entire meeting unless
parental excusal was obtained before the meeting.
Position
Name
Additional Title
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
__________________________ __________________________ __________________________
This form is only to be used when an IEP has been finalized for future dates, and a revision is required for the currently
valid IEP. It is not to be used when there are questions of eligibility or state assessment.
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