1. INDIVIDUALIZED EDUCATION PLAN (IEP) For “Student’s name”

2. Welcome to my IEP!  I will introduce you to my team.  If you have any questions during my presentation, please stop me and share your thoughts and ideas. IEP page 1

3. Reason for Our Meeting My disability is ____________________ I need help in planning my school program IEP page 1

4. Special Things to Consider  English Language Learner  Visual impairment/Blind  Hearing impaired/Deaf  Assistive Technology  Behavior IEP page 2

5. My Skills in School (Strengths and Weaknesses)  Remembering  Listening  Focusing  Comprehending  Reading  Writing  Math  Studying IEP page 3 Thinking SkillsLearning Skills

6. My Skills in School (Strengths and Weaknesses)  Group work  Friend skills  Manners  Organization  Work completion  Self-control IEP page 3 Social SkillsBehavior Skills

7. My Skills in School (Strengths and Weaknesses)  Fine motor  Playground skills  Health  Vision  Hearing  Listening skills  Speaking skills  Following directions IEP page 3 Physical SkillsCommunication Skills

8. My Skills in School (Strengths and Weaknesses)  Bathroom skills  Dressing  Grooming  Doing chores  Eating  I live in ______  I am in ___ grade  I have ___ brothers and sisters  I like to _______  I participate in _____ IEP page 3 Independent SkillsEcological

9. My Goals  Goal 1 How will this goal be worked on? How will we keep track of my progress? IEP page 4

10. My Goals  Goal 2 How will this goal be worked on? How will we keep track of my progress? IEP page 4

11. How My Disability Affects Me At School (Accommodations/Modifications)  In class  With classmates/others  At recess  Transition times (hallway/between classes)  Homework IEP page 5

12. State Assessment  I will not participate this year.  I will participate without accommodations.  I will participate with accommodations. List accommodations: IEP page 5

13. Activities  PE: Reg or Adaptive  Art  Music  FACS  Vocational Ed  Trade & Industrial Ed  Athletics:  Clubs:  Counseling  Recreation:  Transportation  Employment Referrals IEP page 6

14. Summary of My Plan Placement: Reason this is most appropriate: IEP page 7

15. My Special Education Services I will receive (reading, math, classroom support) for (min/week) starting on (date). These services will be for (duration) and be provided by (staff person). I will receive this support in (location). IEP page 7

16. My Special Education Services I will attend school for  A full day  Shorter day  Longer day I will/will not need a summer program because: IEP page 7

17. Comment/Questions  Are there any other comment about my IEP?  Does anyone have any questions about my IEP?

18. Let ’ s Have a Great Year! Thanks for coming and helping me with my plan!