Eastern Upper Peninsula Intermediate School District
315 Armory Place
Sault Ste. Marie, MI 49783
906 632-3373
NONMANDATED AIDE APPROVAL FORM
Verification of Special Education allowable costs for SE-4096.
Local District:
Aide’s Name
School year:
Assignment Description
(Check all that apply)
LRE Class Aide
Program Aide
list:
Individual Student Aide
Substitute Aide
Health Care Aide
Bilingual Aide
(under R 340.1793)
Visual Aide
ECP Aide
Other aide (describe):
(Check all that apply)
LRE Class Aide
Program Aide
list:
Individual Student Aide
Substitute Aide
Health Care Aide
Bilingual Aide
(under R 340.1793)
Visual Aide
ECP Aide
Other aide (describe):
(Check all that apply)
LRE Class Aide
Program Aide
list:
Individual Student Aide
Substitute Aide
Health Care Aide
Bilingual Aide
(under R 340.1793)
Visual Aide
ECP Aide
Other aide (describe):
(Check all that apply)
LRE Class Aide
Program Aide
list:
Individual Student Aide
Substitute Aide
Health Care Aide
Bilingual Aide
(under R 340.1793)
Visual Aide
ECP Aide
Other aide (describe):
FTE
Full time special education
assignment?
Yes
No
Date assigned
Full time special education
assignment?
Yes
No
Full time special education
assignment?
Yes
No
Full time special education
assignment?
Yes
No
I certify the above information is accurate and the aides listed for reimbursement meet the allowable cost requirement of
100% employment in a special education capacity.
Dated:
Signed (Name & Title): ___________________________________________