Barre Supervisory Union
Notice of Extended School Year Decision

School District: _________________________________________ Date: _________________

Dear ___________________________________:

The IEP Team has determined that extended school year programming __ is ___ is not necessary for

_________________________ during the summer of 20_____ because:

___ A summer break without specified special education services will not cause severe regression or loss of skills and/or will not significantly jeopardize the benefits accrued during this school year.

___ A summer break without specified special education services will cause severe regression or loss of skills and/or will jeopardize the benefits accrued during this school year. A copy of the IEP describing the ESY services to be offered is attached.

The IEP Team considered the following information in making its determination:

1. Other options considered (and, if applicable, the reason(s) such options were rejected):



2. Current programs:



3. All circumstances which have seriously impeded, or have contributed to the impeding of student’s progress, and whether such circumstances are related to the student’s disability.



4. Behavior, emotional and physical status as they relate to learning:



5. Attitude and commitment:



6. Evaluation documentation:

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Notice of Extended School Year Decision CODE: IHBA-E
____________________________________________________________________________________

7. Parent comments:




8. Teacher comments:




9. Extent to which the student maintained skills over prior summer (or vacation) breaks as measured by pre-post testing when available:



10. Vocational needs:



11. Review of last year’s ESY program (if any):




Enclosed you will find a copy of Parental Rights in Special Education. If you have any questions, would
like to discuss this further, or would like more information, please contact me at ________________ or write

to me at _____________________________________________________________________________

Sincerely,



Signature: _____________________________________

Printed Name: __________________________________

Position: ______________________________________

Enclosures: Parental Rights in Special Education with Notice Copy of ESY Policy and Procedures

cc: Other: ______________________
Student file

A:pw:Disk T

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