Student 504 Accommodation Plan - DOC by xscape

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									                                                                   Vermont Department of Education

                                                      Educational Support Team (EST) Planning Meeting

Student name: ________________________________ ID#                                                   Birth Date: _______________ Grade: ______

Meeting Date: _____________ Referred By: _____________________________

In attendance:                            ______________________                   _______________________               ______________________
                                          ______________________                   _______________________               ______________________
                                          ______________________                   _______________________               ______________________
                                          ______________________                   _______________________               ______________________

Nature of concern (See referral form for specific details.): ___________________________________________________________
_________________________________________________________________________________________________________


Focusing Question: _________________________________________________________________________________________


Goal: As a result of this plan, the student will _____________________________________________________________________
_________________________________________________________________________________________________________

Brainstormed strategies:
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Educational Support Team (EST) Planning Forms (1/22/08)                                                                                           1
                                                                         Vermont Department of Education

                                                        School Educational Support Team (EST) Student Plan

        Student Name: _______________________ID#                               Birth Date: ________________ Grade: __________
        School: _________________________ Meeting Date: _____________Follow-up Mentor: ___________________________________

Issue(s) to target              Action to be taken                         Person(s)            When/        How will we measure             Results
                                                                           responsible          Frequency/   progress and effectiveness of   (Complete after
                                                                                                Duration     the intervention?               review)




        Plan will be given to: ________________________________________________________________________________________

        Plan will be reviewed on: ____________ by: _____________________________________________________________________

        Any funding or other resources needed to implement this plan (include the source(s): ______________________________________
        _________________________________________________________________________________________________________

        Other support(s) necessary for those implementing this plan (including family members) to be successful in addressing the stu dent’s
        needs: ___________________________________________________________________________________________________




        Educational Support Team (EST) Planning Forms (1/22/08)                                                                                          2

								
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