Special Education Service Request for Homeschool and Non-Public
This is only to be completed for students who have a current, active IEP and attends a non-public school. This will lead to WPS staff contacting the parent and/or non-public school to hold an IEP meeting with the parents/guardians and a representative from the non-public school to discuss current services.
Email
*
example@example.com
Student Last Name
*
Student First Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
*
example@example.com
Non-Public School
*
Please Select
Blake
Brightmont Academy
Fourth Baptist
Hand in Hand Montessori
Providence
Redeemer
St. Bartholomew's Catholic School
West Lutheran High School
Homeschool
Reason for Referral
*
Person Referring (First and Last Name and Title)
*
Student has a current IEP?
*
Yes
No
Current IEP Disability Category
*
Previous School of Attendance
*
Submit
Should be Empty: