Individualized Education Program Page 7
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I N D I V I D U A L I Z E D E D U C A T I O N P R O G R A M
STUDENT’S NAME:
DOB:
TRANSFER OF RIGHTS
(Beginning not later than the IEP that will be in effect when the student reaches 18 years of age.)
Date student was informed that the rights under the IDEA will transfer to him/her at the age of 19
EXTENDED SCHOOL YEAR SERVICES (ESY)
[ ] Yes
[ ] No
The IEP Team has considered the need for extended school year services.
LEAST RESTRICTIVE ENVIRONMENT
Does this student attend the school (or for a preschool-age student, participate in the environment) he/she would attend if
nondisabled?
[ ] Yes
[ ] No
If no, explain:
Does this student receive all special education services with nondisabled peers? [ ] Yes [ ] No
If no, explain (explanation may not be solely because of needed modifications in the general curriculum):
[ ] 6-21 YEARS OF AGE
[ ] 3-5 YEARS OF AGE
Least Restricted Environment:
COPY OF IEP
COPY OF SPECIAL EDUCATION RIGHTS
Was a copy of the IEP given to parent/student (age 19) at
Was a copy of the Special Education Rights given to
the IEP Team meeting?
parent/student (age 19) at the IEP Team meeting?
[ ] Yes
[ ] No
[ ] Yes
[ ] No
If no, date sent:
If no, date sent:
Date copy of amended IEP provided/sent to parent/student (age 19):
THE FOLLOWING PEOPLE ATTENDED AND PARTICIPATED IN THE MEETING TO DEVELOP THIS IEP.
Position
Signature
Date
Parent
Parent
General Education Teacher
Special Education Teacher
LEA Representative
Someone Who Can Interpret the Instructional
Implications of the Evaluation Results
Student
Career/Technical Education Representative
Other Agency Representative
information from people not in attendance
Page
of
ALSDE Approved Feb. 2016
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