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									Student Name _____________________________________________________________                         School __________________________________________________________

                                       Components of the Transition IEP for Students ages 14-21 (to be updated annually)
          Information on these three pages is to be updated each year such that these sections will continue to be part of the student’s IEP each year until he/she graduates.

                                                                      Post School Outcomes (ages 14-21)
                                                                            (602(30)(A); Section 300.27 (a))
 Employment

 Community Participation

 Recreation & Leisure

 Post Secondary Training & Learning Opportunities

 Independent Living


Are graduation requirements attainable and appropriate for the student without modification and adaptations? [ ] Yes            [ ] No
If no, identify modifications and adaptations_____________________________________________________________________________________________
Total number of credits required for graduation__________________________                Anticipated month and year of graduation __________________

                                                            Statement of Transition Service Needs (ages 14-21)
                                                                       (614(d)(1)(vii)(I), Section 300.347(b)(1)(i))
                                                                 List Courses to be taken each year
 School     Grade                      (Identify modifications and justifications for such with the date of change by IEP team)                                         Credits
  Year       Level                                                                                                                                                      Earned
          Grade 8


          Grade 9


          Grade 10


          Grade 11


          Grade 12


 Ages 18-21


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Student Name _____________________________________________________________             School __________________________________________________________

                                               Statement of Needed Transition Services (ages 16-21)
                                                (602(30)(c); 614(d)(1)(vii)(II); Section 300.27, 300.347(b)(1)(ii))
           Transition                   Activities &                                  Agency(ies) &                            Provider &
            Services                     Strategies                                   Responsibilities                           Payer
 Instruction:
 Services not needed because –
 (Section 300.347(b)(2))




 Community Experiences:
 Services not needed because –
 (Section 300.347(b)(2))




 Employment:
 Services not needed because-
 (Section 300.347(b)(2))




 Related Services:
 Services not needed because –
 (Section 300.347(b)(2))




 Adult Living & Post School:
 Services not needed because –
 (Section 300.347(b)(2))




 Daily Living:
 (if appropriate)

 Functional Vocational
 Assessment: (if appropriate)

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Student Name _____________________________________________________________                         School __________________________________________________________


                                                           Agency Collaboration & Responsibilities* (ages 16-21)
                                                                        (614(d)(5); 300.347(a), 300.344 (b)(3)(ii))

    School      Grade                   Needed                         Agency &                  Who will contact &        Timeline for                   Results &
     Year       Level                  Service(s)                    Contact Person                   when                  delivery of                   Outcomes
                                                                                                                            service(s)




*      If any agency identified by the IEP team fails to provide services, the IEP team must reconvene as soon as possible to identify alternate strategies and amend the IEP as
       necessary. Document date of reconvened IEP meeting and results.




    Transfer of Rights: (615(m)1a-c); 300.517(a1-3))
    At one year before the age of majority (18) the student and family must be informed of the educational transfer of rights.
           Date of IEP meeting when transfer of rights was discussed ___________________________________________

    Procedural Safeguards:
    Upon turning 18, document that the student was provided the “Procedural Safeguards in Special Education for Children & Parents” and that all
    rights as educational guardian were discussed.
            Date of IEP meeting when procedural safeguards were discussed ___________________________________________




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