RTI/Student Intervention Team CONFERENCE FORM (revised 10-2010) by 64JB6CO

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									                  RTI/STUDENT INTERVENTION TEAM CONFERENCE FORM
                                 Follow-up Meeting # _____

Student                                               Meeting date
Teacher                                               DOB
Grade

UPDATE OF ONGOING INTERVENTIONS/RESULTS




BASED ON THIS REVIEW, THE SIT TEAM HAS DETERMINED THAT:
ACTIONS/RECOMMENDATIONS                          PERSON RESPONSIBLE                                       TIMELINE

          1. Achievement is noted; continue with interventions,                                        ____________
             strategies, accommodations or modifications

______ 2. Implement additional interventions. Review Possible                                                 ______
          Solutions and/or brainstorm additional solutions to implement.
          Record additional interventions on the Ongoing Intervention Record.
______ 3. A disability is not suspected and the student will not be                                           ______
          evaluated. Prior Written Notice completed and sent to the parent. (Meeting #2 or later)

______4. Request more information/screenings (Meeting #2 or later)                                            ______
_____ 5. Determine if the student is eligible for protection and/or an                                        ______
         accommodation plan under Section 504. (Meeting #3 or later)
______6. Refer to Exceptional Student Education to determine                                                  ______
         if student qualifies for services as a child with a disability.(Meeting #3 or later)

           Complete an Evaluation Review/Compliance Check Request form and use as cover sheet to send packet to
           the ESE Office for ESE compliance check.

Next meeting scheduled for ______________________________ (date).


SIGNATURES
Name                                                  Position                                  Date




                                                                                                          revised 10-2010

								
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