Section 504 Student Services Plan (Page 4 of 4) in pdf

Section 504 Student Services Plan Page 4

Section 504 Services Plan

Form 12, page 4 of 4

Section 504 Services Plan

Additional Notes and Information Page

While checklist forms are convenient, they can also lead to confusion. Please use this page to ensure that

the decisions of the Section 504 Committee are clear to school personnel and anyone else who has

responsibility to implement the Plan or supervise its implementation.

•

For example, where extended time for assignments is checked, indicate the amount of extended

time to be provided (by number of minutes or by percentage, for example).

•

Where other testing accommodation is checked, provide detail as to how the test should be adapted

or the student’s testing experience is to be accommodated.

•

When a reasonable modification of policies, practices or procedures is required, indicate which

policy, etc., and how it is to be modified (Student has extra day to complete written assignments

without normal grade penalty under school’s late-work policy).

This page should be used to document any decision, accommodation or service that does not “fit” the

Service Plan grid. This page should also be used to explain or provide detail for any item or issue where an

entry on the Services Plan is unclear or subject to confusion.

Section 504 Student Services Plan Page 4