1. Student name Insert picture of student

2. Introductions  Student:  Parent(s):  Administrator:  Special Education Teacher:  General Education Teacher:  Diagnostician:  Agency Representative:  Other:

3. Procedural Safeguards A copy of “Rights of Parents and Students With Disabilities” has been received.

4. Purpose Of The Meeting Review eligibility Review placement and performance Review Graduation (or insert picture)

5. Transfer of Rights Is this needed? (Diagnostician)

6. Eligibility and Evaluation Data I qualify for services as a person with (add disability such as ‘a learning disability in written expression’) [Diagnostician], is it time for a reevaluation?

7. Transition I expect to graduate from high school (add month and year) On the (recommended plan or minimum plan) My goal is to: (Work? College? Be specific.)

8. Transition What I’m doing to accomplish this is (completing the college application, applying for financial assistance, meeting with DARS, taking the SAT or Accuplacer, shadowing professionals, etc.). I am working at ?????? approximately ?? hours per week.

9. Present Levels of Performance [Special Education Teacher]?

10. Review of Current IEP Goals [Special Education Teacher]?

11. Proposed IEP Goals [Special Education Teacher]?

12. Proposed Schedule (Academic Year) English Math Science Social Studies Electives Alternates Accommodations for general education classes:

13. State Assessment Latest State Assessment Results: Proposed Assessments: (Academic Year)

14. State Assessment Testing Assurances (administrator reads)

15. End of Year Services/Transportation Statements of need or no need for EYS or transportation

16. Assistive Technology I (do or do not) receive assistive technology. If yes, list:

17. Questions Does anyone have questions or comments?

18. Deliberations Diagnostician

19. ASSURANCES Administrator

20. Mutual Agreements Please sign ARD document and check that you agree. Thank you for your support and time attending today!