Let’s get started!
At least one month before the annual review date
contact your coordinator to schedule the date of
the meeting.
(NOC) Parent/Guardian Notification of
Conference (Form K)
Student’s Name: (Do not use nicknames or shortened
versions of the name.) ISBE states use the student’s legal
name.
First Middle Last
Dates: ISBE states use a six-digit number (month, day, year
09-09-12)
Address the NOC to the parent or guardian. (If the student
is 18 yrs old, the NOC is addressed to the student. If the
student has signed Form Q-2 Delegation of Rights to Make
Educational Decision, include parent in the invited
individual section using name and title. If Q-2 is not
signed, in the bottom left hand corner.
cc parent
NOC (Form K) continued
Purpose of the Conference boxes
Always check box 4 Review/develop IEP
If Domain mtg boxes 1, 4, and Other (write in
Annual Review/Domain Mtg)
If student will be 14 ½ or older (Transition) boxes 4
and 5 (Please remember to invite the student and
outside agency MUST HAVE parent consent (Form
CC) prior to sending invite)
If BIP boxes 4,7,8
Other (write on line Annual Review)
If graduating boxes 4,5,11
NOC (Form K) contiuned
Invited individuals
Parents
Student (if 14 ½)
Outside Agency (MUST have signed CC prior)
Regular Education
Special Education
LEA Representative
Coordinator
Related Service providers (Speech, Social Worker, OT, PT,
Vision, Hearing, etc.)
Interpreter (if needed)
NOC (Form K) continued
As a courtesy please share date, and time of meeting
with related service providers prior to sending out
NOC.
NOC (Form K) Continued
Copy on back of invite – District Behavioral
Intervention Policy
(Please fill out with district’s name, number, contact
person, and put on district letterhead)
Send copies to
One copy to BMP
Copies to your building personnal (reg. ed. Teacher, LEA
Rep., speech, etc.)
3 Notices to parents (1st at least 20 days before AR mtg.,
2nd and 3rd notices need to be documented on IEP)
Sample of Consent to Release or
Obtain Student Information
Parent Consent for Billing Public Insurance
(Form Z-5)
Please fill out top of form Z-5
Student’s legal name (first, middle, last)
Date of birth (use six-digit number 09-09-12)
Attending school
Attending District (name and number)
Resident District (name and number)
Parent/Guardian Notification of Conference
Recommendations (M)
Student’s legal name (first, middle, last)
Dates: use six-digit number (month, day, year 09-09-12)
School year 2012/2013 or 2013/14
Always check box 4
If IAA testing check box 9
If aging out check box 7
If graduating check box 8
Other (write in Annual Review, etc.)
At the meeting, other boxes can also be checked Ex. If
changing related services or placement)
Parent/Guardian Notification of Conference
Recommendations (M)
Please note: That a parent signature and date is
needed if placement is to occur before the ten calendar
day interval.
Page 1 of IEP
Student’s name: Use legal name. Do not use
nicknames or shortened versions of name.
First Middle Last
Dates: use six-digit number (month, day, year 09-0912)
Date of meeting
Date of last evaluation
Date of next evaluation
Page 1 of IEP continued
Purpose of Conference
Check all boxes that apply to indicate the purpose of
the meeting.
If checking the other box, please type in the reason
Page 1 of IEP continued
Student Identification Information
Most of this information can by completed before
the IEP meeting. However, it should always be
checked for accuracy at the time of the meeting.
Do NOT fill in the student’s Medicaid number. This will
be the only space left blank on page 1.
Do Not fill in placement. This section must be
completed following the placement determination.
District must include the name and number of the
school district.
Language/mode of communication
ex. English/verbal
Page 1 of IEP continued
Student Identification Information (cont.)
Ethnicity (This should match what your school has
entered into SIS)
Current grade level (Many teachers are putting both
grade levels covered in IEP so there is not confusion 3/4
or 3rd 2012-13, 4th 2013-14)
Page 1 of IEP continued
Parent/Guardian Information
Most of this information can be completed before
the IEP meeting. However, it should always be
checked for accuracy at the time of the meeting.
Surrogate parent (Indicate if an education surrogate is
required by checking the box provided.)
Language/Mode of communication ex. English/Verbal
Interpreter (Use the yes/no box if interpreter is required
for the meeting.)
Page 1 of IEP continued
Participants
Document the three attempts to notify the parent of
the meeting with (type, date, person)
Participants will sign in at meeting.
If parent is at meeting and an invited individual is not able to
attend, use Parent/Guardian Excusal of an Individualized
Education Program Team Member (Form S)
Page 1 of IEP continued
Procedural safeguards
Fill in date that they were provided to parent
Transfer of Rights
Check appropriate boxes
Parents were given copy of
Check appropriate boxes
IEP (if being mailed put date it was sent)
District’s behavior intervention policies (It was suggested earlier
to copy these to the back of your invite (Form K)
Information Courtesy
Please speak with your administration and discuss
prior to the IEP meeting
IAA (data/documentation)
Extended School Year (data/documentation)
Paraprofessionals (individual and/or classroom)
data/documentation
Order of paperwork
Additional PowerPoint Presentations are available for
remainder of the IEP.
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