This document outlines the personal curriculum process and procedures for general education students in the Forest Hills Public Schools district. It details the steps for a student or parent to request a personal curriculum, including scheduling a meeting with a personal curriculum team to determine eligibility. The personal curriculum team can approve modifications to certain Michigan Merit Curriculum requirements, such as math, social studies, health, or visual/performing arts credits. If approved, the personal curriculum modification plan is implemented, and progress is monitored quarterly.
A slide presentation from a workshop facilitated by Penny Coutas and Kate Reitzenstein for the Westralian Indonesian Language Teachers' Association in December, 2006.
A slide presentation from a workshop facilitated by Penny Coutas and Kate Reitzenstein for the Westralian Indonesian Language Teachers' Association in December, 2006.
Individualized Education Program (Aug 2014 revision) Page 1 .docxjaggernaoma
Individualized Education Program (Aug 2014 revision) Page 1
School District
Special Education Dept
City, State Zip
Student Name: Zach Brehm Grade: 5 Gender: DOB: 4/22/05 Age: 10
Meeting Date IEP Implementation date
Projected Date when services will begin Anticipated Duration of this IEP
School Year
02/03/16 02/12/16 02/02/17 2015-2016
Student Address:
City/State/Zip:
Parent/Guardian Name (include address in section I if different that above):
Contact numbers Home Work(1) Work(2) Cell/Other
Phone
E-Mail
County of Residence: Anticipated Year of Graduation: 2023
If consortium class or Placement: Sending District: School Building:
Current Vo-Tech Student
Future Vo-Tech Student CIP Code:
Primary Disability: Secondary Disability (If applies)
Other Information: Autism, Other Health Impairment, Speech/Language Impairment
*Medical Assistance #:
IEP TEAM/SIGNATURES* Signature on this IEP documents attendance, and not agreement.
The Individualized Education Program (IEP) Team makes the decisions about the student’s program and placement. The student’s parent(s), the
student’s special education teacher, and a representative from the local education agency are required members of this team. Signature on this
IEP documents attendance, not agreement.
NAME (typed or printed) POSITION (typed or printed) SIGNATURE*
Parent/Guardian/Surrogate
Parent/Guardian/Surrogate
Student*
Regular Education Teacher**
Special Education Teacher
Local Educational Agency Rep(Chair)
IEP for
Individualized Education Program (Aug 2014 revision) Page 2
Community Agency Representative
* The IEP team must invite the student if transition services are being planned or if the parents choose to have the student participate. ■ ** If the
student is, or may be, participating in the regular education environment ■ *** As determined by the LEA as needed for transition services and
other community services ■ **** A teacher of the gifted is required when writing an IEP for a student with a disability who also is gifted. ■
One individual listed above must be able to interpret the instructional implications of any evaluation results.
Written input received from the following members: Teachers Name Here
PROCEDURAL SAFEGUARDS NOTICE
I have received a copy of the Procedural Safeguards Notice during this school year. The Local Education Agency has informed me whom I may
contact if I need more information. (Note a copy of the notice may be available on the District Web Page)
Signature of Parent/Guardian/Surrogate:
IEP for
Individualized Education Program (Aug 2014 revision) Page 3
TRANSFER OF RIGHTS AT AGE OF MAJORITY
For purposes of education, the age of majority is reached in Pennsylvania when the individual reaches 21 year.
Directions for how to access the new sample Florida Standards Assessments and see what students will be expected to know in order to successfully complete the new assessments.
Individualized Education Program (Aug 2014 revision) Page 1 .docxjaggernaoma
Individualized Education Program (Aug 2014 revision) Page 1
School District
Special Education Dept
City, State Zip
Student Name: Zach Brehm Grade: 5 Gender: DOB: 4/22/05 Age: 10
Meeting Date IEP Implementation date
Projected Date when services will begin Anticipated Duration of this IEP
School Year
02/03/16 02/12/16 02/02/17 2015-2016
Student Address:
City/State/Zip:
Parent/Guardian Name (include address in section I if different that above):
Contact numbers Home Work(1) Work(2) Cell/Other
Phone
E-Mail
County of Residence: Anticipated Year of Graduation: 2023
If consortium class or Placement: Sending District: School Building:
Current Vo-Tech Student
Future Vo-Tech Student CIP Code:
Primary Disability: Secondary Disability (If applies)
Other Information: Autism, Other Health Impairment, Speech/Language Impairment
*Medical Assistance #:
IEP TEAM/SIGNATURES* Signature on this IEP documents attendance, and not agreement.
The Individualized Education Program (IEP) Team makes the decisions about the student’s program and placement. The student’s parent(s), the
student’s special education teacher, and a representative from the local education agency are required members of this team. Signature on this
IEP documents attendance, not agreement.
NAME (typed or printed) POSITION (typed or printed) SIGNATURE*
Parent/Guardian/Surrogate
Parent/Guardian/Surrogate
Student*
Regular Education Teacher**
Special Education Teacher
Local Educational Agency Rep(Chair)
IEP for
Individualized Education Program (Aug 2014 revision) Page 2
Community Agency Representative
* The IEP team must invite the student if transition services are being planned or if the parents choose to have the student participate. ■ ** If the
student is, or may be, participating in the regular education environment ■ *** As determined by the LEA as needed for transition services and
other community services ■ **** A teacher of the gifted is required when writing an IEP for a student with a disability who also is gifted. ■
One individual listed above must be able to interpret the instructional implications of any evaluation results.
Written input received from the following members: Teachers Name Here
PROCEDURAL SAFEGUARDS NOTICE
I have received a copy of the Procedural Safeguards Notice during this school year. The Local Education Agency has informed me whom I may
contact if I need more information. (Note a copy of the notice may be available on the District Web Page)
Signature of Parent/Guardian/Surrogate:
IEP for
Individualized Education Program (Aug 2014 revision) Page 3
TRANSFER OF RIGHTS AT AGE OF MAJORITY
For purposes of education, the age of majority is reached in Pennsylvania when the individual reaches 21 year.
Directions for how to access the new sample Florida Standards Assessments and see what students will be expected to know in order to successfully complete the new assessments.
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Personal Curriculum Forest Hills Gen Ed
1. FOREST HILLS PUBLIC SCHOOLS
Grand Rapids, Michigan
Date PERSONAL CURRICULUM PROCESS AND PROCEDURES
Completed for General Education Students
and Initials of ** Forest Hills students may not request a personal curriculum until after
Counselor they have completed 9th grade(see pg. 17 of the Course Description Book)**
1 PC meeting requested by:
. Student
Parent/guardian
Staff member
(name)
2 Counselor schedules Personal Curriculum Team meeting for (date/time)
. to determine eligibility for the requested Personal Curriculum (PC). List names of those to
be included:
Counselor
Administrator
Teacher(s) with content expertise
Student
Parent/guardian
Other
3 Staff collects documents to review at the PC Team meeting:
. Most recent Educational Development Plan (EDP)
Most recent MEAP, MI ACCESS of MME results
High school transcript
Report cards and progress reports
End of unit/end of course assessments
Other:
4 PC Team meets, reviews necessary documents, completes the PC Eligibility
. Determination Form and makes recommendation to approve or deny a Personal
Curriculum.
5 If the PC request is denied, the PC Eligibility Determination Form is sent to the Assistant
. Superintendent for Instruction.
6 If the PC request is approved, the PC Team completes the PC Modification Plan, using the
. student’s EDP, signs it and sends it to the Assistant Superintendent for Instruction for
review.
7 If the PC is approved, appropriate staff will implement the PC:
. • It is the responsibility of the parent/guardian or emancipated student to monitor
progress on the Personal Curriculum on a quarterly basis.
• Revisions to a PC must be made using the same process as the original PC.
If conditions set forth in the PC are not met, the student must meet the graduation
requirements specified in the Michigan Merit Curriculum.
Revised March 2009 1
LVJ/knn
2. A copy of this paperwork will be placed in the student’s cumulative record (CA 60)
FOREST HILLS PUBLIC SCHOOLS
Grand Rapids, Michigan
REQUEST FOR PERSONAL CURRICULUM
for General Education Students
** Forest Hills students may not request a personal curriculum until after
they have completed 9th grade(see pg. 17 of the Course Description Book)**
STUDENT INFORMATION (complete each section)
Name of Student: School: Current Grade:
Address: DOB: Yr. of Grad:
Name of Parent/Guardian: Phone: Email:
Name of Counselor: Ext.:
Personal Curriculum requested on by: Student
Date Parent
Staff member
Name
Signature
Received by
USE OF PERSONAL CURRICULUM MODIFICATIONS
A Personal Curriculum may be appropriate for a student who has demonstrated one or more of the following:
o Ability in a specific skill area consistent with a career pathway and/or a post-secondary plan as
determined by the EDP that requires additional or specialized instruction when there are limitations in
time available for elective opportunities.
o Ability to advance in math, science, English language arts or world languages.
o A transfer into the district from out-of-state or from a non-public school with two years of high school
credit.
District may use appropriate assessments to determine what credits were earned out of state or at
a nonpublic school.
The PC plan must include a .5 civics credit and a math course the final year at least equivalent to
Algebra I or the course following Algebra I.
MODIFICATIONS NOT NEEDING A PERSONAL CURRICULUM
Taking credit requirements through KCTC courses, humanities, industrial education or applied
arts courses.
Earning credit through Advanced Placement or approved dual enrollment courses.
Spreading a credit over two yeas with a student receiving ½ credit per year (eg. Algebra I,
Physics, etc.)
Taking both a credit requirement and support course (eg. Geometry and Geometry support)
REQUIREMENTS THAT CANNOT BE MODIFIED
English Language Arts (4 credits )
Science (3 credits including biology and chemistry or physics)
Civics (.5)
Online Learning Experience (20 hours – see page 25 of the FHPS HS Course Description Guide)
Revised March 2009 2
LVJ/knn
3. MODIFICATION REQUEST
Select the area(s) of the Michigan Merit Curriculum that are proposed for modification(s):
Algebra II (1 credit)
Completion of .5 credit of Algebra II and a four year course plan indicating a minimum of 4
credits in math including math in the final year
World History/Geography (1 credit)
Student must have completed two credits of social studies, including Civics
Attach EDP and four year course plan indicating additional course work in math, science,
English and/or world language
Health (.5 credit)
Attach EDP and four year course plan indicating additional course work in math, science,
English and/or world language
State law requires students to have STD and HIV instruction.
Physical Education (.5 credit)
Attach EDP and four-year course plan indicating additional course work in math, science,
English and/or world language
State law requires students who are physically fit and capable to take a physical education
course; so, however districts may credit a student’s participation in athletics and other extra
curricular activities involving physical activity as meeting the physical education
requirement. (MDE Personal Curriculum Meeting 12/12/2008)
Visual, Performing and Applied Arts (1 credit)
Attach EDP and four-year course plan indicating additional course work in math, science,
English and/or world language
SOURCES OF EVALUATION INFORMATION
(Check each document used to determine eligibility for the Personal Curriculum and attach the data that supports the
recommendation.)
Educational Development Plan
Career Goal
Four year course plan attached
ACT Plan/ACT Workkeys, ACT, PSAT, SAT
Attendance/behavioral records
Curriculum assessments
Grades
MEAP/MME Scores
Teacher input
Other (specify)
MICHIGAN MERIT CURRICULUM CREDIT AUDIT:
(Please check any/all boxes that apply.)
4 English/LA 4 Math 3 Science 3 Social Studies 2 Other
8th grade Foundations of
English 9 Algebra I . 5 Civics .5 Health
Science
.5 Physical
English 10 Geometry Biology . 5 Economics
Education
US Visual, Performing
English 11 Algebra II Chemistry or Physics
History/Geography and Applied Arts
Senior Yr. 3rd year of Science if 8th World 20 Hour On-line
English 12
Math grade credit not granted History/Geography Learning
Revised March 2009 3
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4. PERSONAL CURRICULUM RECOMMENDATION:
PC Not Recommended – describe rationale:
PC Recommended for the areas checked below – describe rationale:
Math Physical Education
Social Studies Visual, Performing
or Applied Arts
Health
Student
Parent/Guardian
Counselor
Principal or designee
Teacher(s) with content expertise
Other
If Personal Curriculum is recommended, have student and parent read the following and sign below:
My signature below indicates that I understand:
o I am responsible to maintain communication quarterly with teachers regarding the areas of modification.
o This PC is null and void if I do not achieve proficiency in the required credits and I will be required to
take the substituted credits in order to earn a high school diploma.
o I understand that modifications to the Michigan Merit Curriculum may limit my readiness to be admitted
to college, be eligible for college scholarships, enter trade school, secure a job in a career choice or be
eligible for NCAA athletic programs.
Student Date
Parent/Guardian Date
DISTRICT COMMITMENT
I approve this personal curriculum request.
Implementation date (Month/Day/Year) / /
I deny this personal curriculum request.
Signature Date
Assistant Superintendent for Instruction
Revised March 2009 4
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5. A copy of this paperwork will be placed in the student’s cumulative record (CA 60)
Revised March 2009 5
LVJ/knn