Guardian Request for Evaluation and/or Accommodations

- Academics

The maximum number of form submissions has been reached. This form is currently not available.
- If you wish for your child to be considered for accommodations due to a qualifying learning disability, medical diagnosis, or psychiatric diagnosis please complete the form below.
  
  Please be aware that submission of the form is not a guarantee of services; rather, it serves as the guardian request for consideration.
- Contact Information:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED
  
  Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Student Data:
  
  Student Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Current Grade: REQUIRED Please fill out this field.
- Has your student received special education services or had academic supports in place previously? REQUIRED Yes No Please fill out this field.
- If you answered "yes" to the question above, please select the type of services your student has had. REQUIRED Please fill out this field.
- Services Requested: REQUIRED
  Please select the services you are interested in for your child after reading the information below. Please submit any relevant documentation (medical documentation, previous 504/IEP/NPSP) to Mrs. Boros ([email protected]).
  Accommodations Plan (similar to a 504) Non-Public Service Plan (similar to an IEP) Please fill out this field.
- Non-Public Service Plans:
  When a child is enrolled in a nonpublic school by the parents, the public school district’s obligations are different than for children enrolled in public schools. Eligible students in public schools receive individualized special education programs and services through an IEP. Eligible students who attend nonpublic schools receive services through a nonpublic services plan. The services are determined through a process between the public school district and the nonpublic schools, based on the required share of federal funding and the needs of the student. The services are provided by the public school district. Nonpublic schools are not bound by special education law.
- By checking this box, I agree that I am the legal guardian of the identified student. I further consent to release my child's information to Saginaw Township Public Schools in order to coordinate services for my child.
  I Agree Please select this field.
- Please type your name below to serve as an electronic signature. REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter a date.
Submit
Links & Resources
- Special Education in a Non-Public School
- 504 Plan versus IEP

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Guardian Request for Evaluation and/or Accommodations

Links & Resources