EDUCATIONAL SERVICES REQUESTED Does this student qualify for Special Education services? Yes No (Must have an active IEP and a current evaluation) completion of the placement test, does this student qualify for TBIP (Transitional Yes No Bilingual Instruction Program) services? Does this student qualify as Exited TBIP? Yes No (To qualify, the student was receiving TBIP services in the previous school year and/or current school year, and scored a 4 in the annual WELPA test in either the spring of those years.) COURSES REQUESTED (Include course or coursework description, credit, % of the day, etc.) Resident School Nonresident School Grades K-12 Skill Center Running Start Please see third page for important notices, acknowledgements, and signature. NOTICES
EDUCATIONAL SERVICES REQUESTED Does this student qualify for Special Education services? (Must have an active IEP and a current evaluation) Yes No completion of the placement test, does this student qualify for TBIP (Transitional Bilingual Instruction Program) services? Yes No Does this student qualify as Exited TBIP? (To qualify, the student was receiving TBIP services in the previous school year and/or current school year, and scored a 4 in the annual WELPA test in either the spring of those years.) Yes No COURSES REQUESTED (Include course or coursework description, credit, % of the day, etc.) Resident School Nonresident School Grades K-12 Skill Center Running Start Please see third page for important notices, acknowledgements, and signature. NOTICES
InterdistrictAgreementRequestInputReady.docx