STUDENT SERVICE PLAN FOR PARENTALLY PLACED PRIVATE SCHOOL STUDENTS _______________County Schools Student’s Full Name ___________________________________ Date___________________ PART VII: PLACEMENT Ages 3-5 WVEIS LRE Code ___ Service provider location or some location that is not in any other category S Ages 6-21 WVEIS LRE Code ___ Parentally placed in private school (Service Plan only) 8
STUDENT SERVICE PLAN FOR PARENTALLY PLACED PRIVATE SCHOOL STUDENTS _______________County Schools Student’s Full Name ___________________________________ Date___________________ PART VII: PLACEMENT Ages 3-5 WVEIS LRE Code ___ Service provider location or some location that is not in any other category S Ages 6-21 WVEIS LRE Code ___ Parentally placed in private school (Service Plan only) 8
SpecialEducationProcessFormswithInstructionsRevisedSeptember-2017.docx