Example
NOTICE AND INVITATION TO ATTEND
AN IEP TEAM MEETING
be ME. TIM ¢ MNS. Tina THMMY Tommy oae:II12 15
Coats) TOMY (Baadent}
"Students 16 yrs. and older must be invited to this meeting,
You are invited to attend a meeting for Ti mmy Tormimy to discuss transition services
fame of Stet)
‘The purpose(s) of this meeting is as follows: (check all that apply)
C1 To determine initial eligibility for special education programs or related services, and if appropriate, to develop an
individualized education program (IEP) for this student.
1D. To review the comprehensive special education re-determination.
EX To review and/or revise this student's individualized educational plan.
D2 To consider the need for a change/additional disability
(O To discuss an evaluation plan for this student.
To discuss disciplinary action that may result in change of placement.
To discuss the students exit IEP or graduation.
1 Other purpose or comments:
This meeting is scheduled for:
time: 7:00 am Pate: | 115/20[(9 Pace: HONONA High
‘The members appointed by the superintendent are as follows:
Parent or guardian: Tir ¢ Ting TOMMy — METRepreseniaive: MISS SCHOO! psychologist
District Representative: [VII Principal Student: Ti My Tommy
Special Bdueation wiv ayia, Freyling General Baueaton Ware ance
Other (name & role: FLCC Other (name & role): MAX BUS
Members will be responsible for presenting information and to help determine the eligibility, educational needs and the
special education programs and/or related services to be provided to your student. Please be prepared to share any
information that might be helpful in making these important decisions.
+ You may be accompanied by other individuals who have knowledge or special expertise regarding your child.
+ Copies of "Procedural Safeguards Available to Parents of Children with Disabilities" must be provided at least one time
per year or at parent request. Additional copies may be obtained by calling the special education director of your district.
+ Ifyou have any questions or concems about this meeting, please contact the person listed below.
Sincerely (name & address) Phone: Email: MiAayla .Preylingd @
Mitayla Freyiing (oll) 123 - 4507 hope.ed 4
Holland: Hi
00 van Raatte Ave
Holland, MI
49423
Rev. 6/85 F407Ottawa Area Intermediate School District
CONSENT TO INVITE COMMUNITY AGENCIES TO AN
INDIVIDUALIZED EDUCATION PROGRAM (IEP) TEAM MEETING
School Disc ie i | vate: 11 /20 /15
swerve: TIMMY “ZOramy ernpa 12/18 72000
PURPOSE
oon Mr. Tim 4 Mrt. Tina Tommy
‘Tho schol dicts remired to inv community agencies tote IEP Team meeting who are hel to rove or pay fr services ale student eaves school
Betws asf community agence the school ste! woud ke tonite, Weak your consent sen these agencies an chon fr lEP Tean sings ha
willbe hel during te vcaming school yea.
‘Agency representaivos bring importa! information and resoucs othe IEP Team meeting, for any reason you have question regarding this request, lease
cnlact us a8 son 28 posible Should you choose oto respond io his request, the scald may not send a invitation to these agence.
ADDITIONAL INFORMATION
‘+ The individuals wih Disables Act (IDEA) species that by te time a student reaches age 1, the school dist must invite cemmuniy agencies tothe IEP
Team meeting they ate Skely to provide or pay fr services afer he student leaves schoo,
= The schoa istrict mut seek your consent andi responsible for invting agency representatives, The schocl dst may not require that a pail
representative ofthe agency attend.
Agency representatives are not required to attend the IEP Team meeting.
+ Youmay cect inite any agency (incuding those not on he Hist below) thet you fel would be appropiate fo tend the IEP Team meting,
COMMUNITY AGENCIES
\We are requesting your permission to invite the ised community agencies, Please wit your nia net fo each individual agency, indleating your consent 0 nv,
‘and signin the space provided below,
CONSENT TO INVITE
"hereby authorize the school dsc to invite the community agencies | have intaled above | understand that his authorization wil expire one year fom the date of
my signature unles otherwise spectied and that his authorization may be wthdraun by me at any time wehout prejudice.
Smaredcovee —(pArcIHt SiQMAtUCAS
-
CONTRACT AND SIGNATURE
If you have questions regarding any ofthis information please do not hesitate to contact me.
PLEASE SIGN AND RETURN FORM WITHIN 7 DAYS To:
Respectuy, ‘Schoo Ades: Ve
0,
Mi
7
New: $3009
Schoo! Telephone 1 =fstudent Timmy Tommy iat: 12/18/2000 poate |/)5/1(0
Transition Considerations
Course of Study Addressing Post School Transition Needs for Post-Secondary Adult Activities ~ Consider te folowing fr any student who
will reach age 18 curing this IEP and review at eech subsequent IEP. Check one:
‘TZ General andor special education classes leading toadloma [1] Course of study leading toa certticate of completion
‘Comments:
Invitations and Contacts:
Agencies Invited (it any): GRCC # MAX Bus pate: 11/20/15
Student nvtaton By: /Y]iV/Q) ya Freplin Method of Contact AVVIQY | vate 11/20 /IS
Ifthe student cid not attend ieay the steps tndt were ken to ensure the consideration of the students preferences and goals were:
students Post-secondary Goats
1. CareesiEmployment: As an adult, what kind of work do you want fo do?
2 a een ‘After high school, Cre Tet want?
te fol 10 tale
Oa adult, wher Mone it C -
4 (pan anh ‘As an adult, tert a
pl {y ip Norn ty C country ¢ Snop, can, ¢ clean. __|
Staten of Needed Transfon Services Consider okwng fo any Ser whole ge 16 ng tas EP and revo ray
Needed Transition Activities/Services based on age-appropriate transition Responsible Timeline
assessments related to the student’s PLAAFP. o ‘Agenoy Person
few Tw =
eed +0 Find Ovt about +Wo year ie tis 2
elgg tc cad
Relat
need to enon! now to advocate toro (epaysinen
ico cree
| need to understand sale prices. Tranetnan
Employment ; TI None
Ineed to “now /i€arn. how to be_pui yal Mes
Lig oncol lace, 4 pcofticna a ons ;
| need to learn Now +o vore. ee
Sa SE rantinion
need +o 1€arn how 40 prepare nifceeious ae
|! coe tit rd +0 pe ccaed on a Stove Yvan. Curriculom
Mneect "0 tiow Vw +0 Apply for post ee y
econdary + Dining...
Parental Rights and Age of Majority (Cleck al aplcable
1 Hthe student will be age 17 dung this IEP, the student was informed of parental rights that wil raster to himher at age 18.
tthe student has tuned age 18 the student and parent vere informed ofthe parental gh that transferred fo the student at age 18,
The student has turned age 18 and there is @ quardian established by court order. The guardian is:
F40Tb Rev. 805 Page 1bPLAAF
NOW WRITE ONE FOR YOUR HOLLAND STUDENT.
Timmy Tonmy “ng me EsTe-J on October 50, 20/5. Timmy
Tommy ¢txnibitt nignest i¢vel OF strengths in ¢ne arear oF
geercation 4 Leisure 4 Employmart witn (00% mastery in ZecreaKen
4 leisure # 92% in Employment Arcos of netd for Timmy Tommy
Moy include community participation with & 57% mastery + Home
LIVING WHN a 93% mastery. UNder Community Participation, Timmy
Tomrny reeds to work on unoersrancing. cost 4 savin
Fecnniques, purchating options 4 phy for 1arge purchases in the
Community 4 bose insurance needs. Unde” Home Livin _ Trmmy
men recat 40 wore on practicing preventive matin Eare,
= “tone bovine a money responsibly, + uncer
bittt. His pans’ afer AoA counts. Tinmimy Tommy enjeye olirt
TEN unter Por aug meoreniar i goa ‘t Ghee ila
Apartment by himcet (wien ; ¢ in an
rig aut oF igh tone!" 4 POY BINM) A he age oF 19