Good Cause Exemption

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S O U T H B E N D C O M M U N I T Y S C H O O L C O R P O R A T I O N
S P E C I A L E D U C A T I O N S E R V I C E S
I R E A D - 3 G o o d C a u s e E x e m p t i o n
Student:
STN: ___________________ ID: _______________
DOB:
School:
IRead-3 Score: ____________
Passing Score: ____________
The above named student qualifies for special education services and therefore may be eligible for a
Good Cause Exemption from the IRead-3 retention requirement.
• The case conference committee must meet to determine whether to exercise the good cause exemption
for this student.
• The case conference committee should consider previous academic achievement and information on
the student’s IEP in making this decision.
• The committee should make the determination based on the best interest of the student.
The Case Conference committee has determined:
rd
_____The student will be retained in the 3
grade.
_____The student will receive a Good Cause Exemption and be placed in 4
th
grade.
_____The student will participate in IRead-3 remediation, retest, receive the Good Cause
th
Exemption, and will be placed in 4
grade.
Members of the IEP team made this determination on ___________________________________(date)
Print Name
Parent / Guardian
________________________
Building administrator/ designee
________________________
TOR
________________________
General education teacher
________________________
________________________
Attach copies to IEP and distribute: Parent, Cumulative File, Special Education
Department

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