Get Notification Of Intent To Seek Approval For Individual Student Program-28m3 Form - Doe Mass

Filling out the Notification Of Intent To Seek Approval For Individual Student Program-28M3 form is essential for school districts seeking approval for placing students in unapproved programs. This guide provides a clear and supportive walkthrough for each section of the form to ensure accuracy and completeness.

Follow the steps to complete the Notification Of Intent To Seek Approval form effectively.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Fill out Section I: Student Information, providing the student's first and last name, date of birth, middle initial, gender, disability type, SASID number, and date of the current IEP.
3. Complete Section II: School District Information by entering the name and code of the school district, contact person's details, address, telephone number, and email.
4. In Section III: Justification, briefly describe the reasons for placing the student in the selected program. Include information about the attempts made to seek approved programs and how the needs of the student are being addressed.
5. Move to Section IV: Student Placement Information. Indicate whether it's a day school or residential placement, and if it's an initial or renewal application. Fill out the proposed placement start and end dates.
6. In Section V: Special Education Placement Information, provide the agency name, primary contact person, agency address, telephone number, email, school/program name, and program code.
7. Read and complete Section VI: Public School District Special Education Administrator's Statement of Assurances to certify that all necessary criteria have been met. Include the administrator's name, signature, and date.
8. If relevant, complete Section VII: Private School Special Education Administrator's Statement of Assurances with similar information as in Section VI, ensuring to sign and date appropriately.
9. Review all entered information for accuracy. Save any changes, and make sure to download or print the completed form if necessary.
10. Finally, send the completed form and required documentation to the appropriate department, maintaining local copies for future reference.

Complete your documents online today for a seamless submission process.