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Kern County Consortium SELPA
Working together for the success of all students!
Contact us!
Greg Rhoten, SELPA Director
Telephone: 661.636.4801
Fax: 661.636.4810
1300 17th Street
City Centre
Bakersfield, CA
93301-4533
Contact us!
Jennifer Acuna, SELPA Coordinator
Telephone: 661.636.4884
Fax: 661.636.4810
1300 17th Street
City Centre
Bakersfield, CA
93301-4533
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Kern County SELPA Forms
Special Education Local Plan Area
SESP Forms May 2009
English Forms
"Notice of IEP Meeting" (
Rev. 5/09
)
"Referral for Evaluation"
(
Rev. 5/09
)
"Summary of Performance Exit Report "
(
Rev. 5/09
)
"
Parent Contact Log
" (
Rev. 5/09
)
"MIS Data Collection Form"
(
Rev. 5/09
)
"Triennial Assessment Worksheet/Summary" (
Rev. 5/09
)
Amendment to IEP
(
Rev. 5/09
)
"Individual Transition Program"
(
Rev. 5/09
)
"
R03: Referral for Evaluation"
(
Rev. 5/09
)
"
R04: Consent for Assessment"
(
Rev. 5/09
)
"R05: Parent/Guardian Notice of IEP Team Meeting"
(
Rev. 5/09
)
"R06: IEP"
(
Rev. 5/09
)
"R07: Present Levels/Performance Data"
(
Rev. 5/09
)
"R08a: Special Factors to be considered "
(
Rev. 5/09
)
"R08b: Specific Learning Disabilities Documentation"
(Rev. 5/09)
"R09: General Education Participation Plan"
(
Rev. 5/09
)
"R10: Goals and Objectives"
(
Rev. 5/09
)
"R16: Continuum of Services and placement options
" (
Rev. 5/09
)
"R17: Consent for Placement in Special Education"
(
Rev. 5/09
)
"R18: IEP Team Meeting Notes"
(
Rev. 5/09
)
"R20: Extended School Year Eligibility Form"
(
Rev. 5/09
)
"R22: Letter to Parent Following IEP Team Meeting"
(
Rev. 5/09
)
"R31: Supplementary Aids & Services"
(
Rev. 5/09
)
"R26: Behavior Support Plan"
(
Rev. 5/09
)
"R33: 30-Day Placement Approval"
(
Rev. 5/09
)
Consent and Agreement to Excuse Required IEP Members
Spanish Forms
"
Summary of Performance Exit Report "
(
Rev. 5/09
)
"Triennial Assessment Worksheet/Summary
" (
Rev. 5/09
)
"
Amendment to IEP
" (
Rev. 5/09
)
"Individual Transition Program"
(
Rev. 5/09
)
"R03: Referral for Evaluation"
(
Rev. 5/09
)
"R04: Consent for Assessment"
(
Rev. 5/09
)
"R05: Parent/Guardian Notice of IEP Team Meeting"
(
Rev. 5/09
)
"R06: IEP"
(
Rev. 5/09
)
"R07: Present Levels/Performance Data"
(
Rev. 5/09
)
"R08a: Special Factors to be considered "
(
Rev. 5/09
)
"
R08b: Specific Learning Disability Documentation"
(
Rev. 5/09
)
"
R09: General Education Participation Plan"
(
Rev. 5/09
)
"R10: Goals and Objectives"
(
Rev. 5/09
)
"R16: Continuum of Services and placement options"
(
Rev. 5/09
)
"R17: Consent for Placement in Special Education"
(
Rev. 5/09
)
"R20: Extended School Year Eligibility Form"
(
Rev. 5/09
)
"
R22: Letter to Parent Following IEP Team Meeting"
(
Rev. 5/09
)
"R31: Supplementary Aids & Services"
(
Rev. 5/09
)
"R26: Behavior Support Plan"
(
Rev. 5/09
)
Consent and Agreement to Excuse Required IEP Members