LAURENS COUNTY SCHOOL DISTRICT 55
Office of Programs for Students with Disabilities
1029 West Main Street  Laurens, SC 29360
(864) 984-3568
Agreement For IEP Amendment Without IEP Meeting
Student: _________________________________________ Date of Review: ___________________
Amendment Requested by: __________________________________________________________
Request Reviewed by: ______________________________________________________________
Recommendation for Amendment: _____________________________________________________
Parent Contact Information: ___ Phone ___ Email ___ Home Visit ___Letter ___ Conference
IEP TEAM MEMBER SIGNATURES
The individuals below agree to amend the IEP of this student as specified above and understand their
responsibilities regarding the implementation of this change. The individuals below agree that a
formal IEP meeting is not needed for this change.
Signature
Position
Date
___________________________
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_________________
___________________________
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_________________
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_________________
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PARENT STATEMENT
I agree with the change made to my child’s IEP as outlined above. I agree that a formal IEP Meeting
is NOT needed for this change. I understand that I will receive a copy of this document, along with a
Prior Written Notice.
___________________________________________________________
Signature
___________________
Date
Document No. 3130 State Board of Education
Chapter 43-243, Special Education, Education of Students with Disabilities Statutory Authority: Individuals with Disabilities Education
Improvement Act of 2004 IV.E (a) (4) (i) In making changes to a child’s IEP after the annual IEP Team meeting for a school year, the
parent of a child with a disability and the public agency may agree not to convene an IEP Team meeting for the purposes of making
those changes, and instead may develop a written document to amend or modify the child’s current IEP.