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Permission For Community Training

South Bend Community School Corporation

Special Education Services

PERMISSION FOR COMMUNITY TRAINING

Student Name: __________________________ SBCSC ID#: ______________ STN#: ____________________

Date: ________________________________

Dear ________________________________

We are planning to provide _____________________ direct instruction in the local community as described below.

Site(s) that may be used for instruction include but are not limited to:

__________________________________________

______________________________________________

__________________________________________

______________________________________________

__________________________________________

______________________________________________

To meet instructional needs as part of the current Individualized Educational Plan for your student the following

skills will be worked on in community settings:

__________________________________________

______________________________________________

__________________________________________

______________________________________________

This student will be supervised at all times by a special education teacher, school therapist, or a special

education para-educator. Students will walk, or will be transported by SBCSC vehicles or TRANSPO.

Please sign the permission form below and return it to the school as soon as possible. Thank you for your

assistance and cooperation. If you have any questions or concerns regarding community-based instruction or

activities, please do not hesitate to call me.

You may reach me at: _________________________________________________________________________

Sincerely,

Special Education Teacher

I give my permission for: __________________________ to participate in community based instruction as

described in the objectives in the IEP of my student. I understand that this is an ongoing part of the IEP, and that

this part of the IEP may be reevaluated at my discretion.

Parent/Guardian signature: __________________________________________ Date: ______________________

Permission granted covers the current school year.

8/18/12

Permission For Community Training