Parent Consent for Formal Evaluation Proposal
Dear
:
The Intervention Plan for Student Success developed for your child,
,
recommended that additional information is needed to strengthen our planning and to better address your
child’s improved educational performance. At a recent Student Support Team meeting, the enclosed
Formal Evaluation Design was developed and is proposed to you for your consent. This Formal
Evaluation proposal is intended to provide you and the school with more specific information about your
child’s strengths and needs. This may help determine your child’s eligibility for any specially designed
services.
Before making this Formal Evaluation proposal, the following options were considered, but rejected for
the reasons stated:
The data and other information used to support this proposal are stated in the strengths and needs section
of the Formal Evaluation Design. The following are additional factors, which are relevant to the Formal
Evaluation proposal:
Enclosed with the proposal is the New Hanover County Schools Parents’ Rights Handbook, which
provides you with a full explanation of your procedural safeguard with respect to this proposal.
If you agree with this proposal for a Formal Evaluation, please sign below and return this notice to me.
You will be invited to a meeting to discuss the results of the Formal Evaluation and participate in any
additional planning activities, which may follow. If you have any questions or require any additional
information about this proposal, please contact me.
Sincerely,
Enclosures
Revised: 1/09
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Parent consent for Formal Evaluation Proposal
YES, I understand and agree to the Formal Evaluation Proposal described in this notice. I understand that my
consent is voluntary and may be revoked at any time.
_______________________________________________ _______________ ____________________________
Signature
Date
Relationship
NO, I do not agree to the Formal Evaluation Proposal described in this notice.
_______________________________________________ _______________ ____________________________
Signature
Date
Relationship