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:
Relationship to Student:
Mark only one.
I certify that I am the students legal guardian.
Student Date of Birth
Benton Grade #47
Benton High #103
Ewing Grade #115
Franklin Jefferson SpEd #801
Grand Prairie Grade #6
MtVernon H.S. #201
Rome Grade #2
Spring Garden #178
How do you wish to receive your written materials?
Mark Only One.
I do not want to receive any written before an IEP meeting. I agree that this decision in voluntary and that I can change my decision at any time by contacting Amy Shreves at Franklin Jefferson Special Ed Central Office (618) 4397231.
Please make a copy of the written materials available at the main office of my child's school. I will pick up the written materials (3) school days prior to the meeting
Please email all written materials to the following email address(es) three (3) days prior to the scheduled IEP meeting or eligibilty meeting
List all applicable email addresses below
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