Designation of Written Materials

Under Public Act 101-515, school districts are required to provide all written material that will be
considered by the IEP team - other than the components related to the educational and related service
minutes proposed for the student and the student's educational placement - to the student's
parent/guardian at least three (3) school days prior to the IEP eligibility meeting or IEP meeting. The
District understands that the contents of these written materials are confidential. Please indicate how
you would like the District to deliver the IEP written materials to you:
Name of Person Completing Form: *
Your answer
Relationship to Student: *
Mark only one.
I certify that I am the students legal guardian. *
Required
Student Name: *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
School District *
How do you wish to receive your written materials? *
Mark Only One.
Email Address
List all applicable email addresses below
Your answer
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