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'LVWULFWRU6SHFLDO(GXFDWLRQ&RRSHUDWLYHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB  6WUHHW&LW\6WDWH=,3&RGH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB $GGUHVV 3KRQH1XPEHU,QFOXGH$UHD&RGH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB   3$5(17&216(17)25$*(1&<,19,7$7,217275$16,7,210((7,1*  Date: ___________________ Dear Parent/Guardian of ______________________________ Your child’s annual IEP meeting, including consideration of needed post-secondary goals and transition services, will be held this school year. To the extent appropriate, we must invite a representative of the agency or agencies which may be responsible for providing post-secondary transition services. In order for us to invite these agency representatives, we need your written consent. 7KHVSHFLILFDJHQF\DJHQFLHVWKDWZHZRXOGOLNHWRKDYHUHSUHVHQWHGDW\RXUFKLOG¶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lease sign below indicating your consent or refusal for that agency to be invited to the IEP meeting. Sincerely, _____________________________________ Case Manager

_________________ Phone

3OHDVHFKRRVHRQH  ___ I 'Rgive my consent to have the above listed agency/agencies invited to IEP meetings. I understand that my consent is voluntary and may be revoked at any time before the identified agency representatives have been invited to the IEP meeting. ___ I 'R1RW give my consent to have the above-listed agency/agencies invited to IEP meetings. _________________________________ Signature of Parent/Guardian

Illinois State Board of Education Special Education Services Division August 2009

_________________ Date

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