SPECIAL SERVICES STATE / FEDERAL PROGRAMS

Form Name	Due Date
Request for Tuition Placement of Students with Disabilities EF-S-01	As Required
Request for Special Education Contract Approval EF-S-03 in doc Instructions in Word	15-Oct or As Required
State Agency Client Request for Reimbursement Report EF-S -04A-B Instructions Regulations and Statutes Recorded Webinar	As Required 15th of each month
Report of Services to Students with Disabilities Parts I & II EF-S-05 Login Page	31-Dec
Request for Subsidy Allocation of Tuition & Board for Students with Disabilities MEDMS/EF-S-07	16-Sept
Local Entitlement Application -- Special Education EF-S-08	15-Sept
Annual Financial Report of Federal Program Expenditures -Education of Handicapped - IDEA Local Entitlement EF-S-09E	1-Sept
Year-End Report of Special Purpose Private Schools (CARES) EF-S-10	31-Aug
EPS High Cost Out-of-District Placement Adjustment EF-S-214 in XLS FY 12 EF-S-214 Instructions Word	16-Apr
*Contacts:* Denise Towers or Nancy Connolly Tel: 207-624-6655 Fax: 624-6683

SCHOOL FORMS

Form Name	Due Date
Advance Written Notice of I.E.P./I.F.S.P. Team Meeting in RTF or MS Word	(For Local Use Only)
Determination of Adverse Effect on Educational Performance in RTF or MS Word	(For Local Use Only)
Parental Consent for Evaluation in RTF or MS Word	(For Local Use Only)
	(For Local Use Only)
Individualized Education Program (IEP) IEP form in word IEP form in PDF IEP form in HTML IEP with Guidance and Exemplars in RTF or MS Word IEP Guidance Document in RTF or MS Word	(For Local Use Only) (For Local Use Only)
Written Notice in RTF or MS Word	(For Local Use Only)
Documentation for Excusal of IEP Team Member Whose Curriculum Area IS Being Discussed in RTF or MS Word	(For Local Use Only)
Documentation of Agreement of Non-Attendance for IEP Team Member Whose Curriculum Area IS NOT Being Discussed in RTF or MS Word	(For Local Use Only)
Learning Disability Evaluation Report in RTF or MS Word	(For Local Use Only)
Summary of Performance in RTF or MS Word Sample 1: in RTF or MS Word Sample 2: in RTF or MS Word	(For Local Use Only)

*Contact:* Susan Parks Tel: 207-624-6644 Fax: 207-624-6641
Form Name	Date
Individualized Family Service Plan (Part C IFSP) in RTF or MS Word (Sample IFSP is being developed and will be placed on the website when it is completed.)	As Required
Contact: Cindy Brown Tel: 207-624-6660 Fax: 207-624-6661

Form Name
Severity Rating Scales/Guidelines for Speech/Language Communications Services in RTF or MS Word	As Required
Speech/Language Eligility Criteria in RTF or MS Word	As Required
Teacher Input - Articulation in RTF or MS Word Fluency in RTF or MS Word Functional Communication in RTF or MS Word Language in RTF or MS Word Voice in RTF or MS Word	As Required