Iep Revision Form - South Bend Community School Corporation Special Education Department Page 12
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13Notice of Implementation
I have been presented with a copy of the Individualized Education Program (IEP) which contains:
1) A description of the action proposed by the public agency;
2) An explanation of why the public agency proposed to take the action;
3) A description of each evaluation, procedure, assessment, record, or report the agency used as a basis for the
proposed action;
4) A description of other options that the case conference committee considered and the reasons why those op-
tions were rejected; and
5) A description of other factors relevant to the agency’s proposal.
I understand that the public agency is not required to obtain a written parental consent and can implement this IEP ten
(10) instructional days after the provision of this notice unless I challenge the proposed action by:
• Requesting and participating in a meeting with an official of the public agency who has the authority to facilitate
the disagreement between the parent and the public agency regarding the action proposed or refused by the
public agency.
• Securing an agreement for mediation under 511 IAC 7-45-2.
• Requesting a due process hearing under 511 IAC 7-45-3.
In the case of an initiation date that is prior to expiration of ten (10) instructional days, I give my consent to implement
the IEP.
CONSENT TO IMPLEMENT IEP
I have been provided with the Notice of Implementation and a copy of the proposed IEP. I give my consent for the
School to implement the IEP in accordance with the initiation date that is prior to the expiration of ten (10) instructional
days from the date the Notice and proposed IEP were provided to me.
_______________________________________________
_____________________________________________
Sign
Date
I understand that a parent of a student with a disability has protection under the procedural safeguards which are pro-
vided with this notice and that I can request a copy of the procedural safeguards at any time. The procedural safe-
guards document includes a list of resources to contact for assistance in understanding the provisions of Indiana special
education rules.
_______________________________________________
_____________________________________________
Sign
Date
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