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s
STUDENT INFORMATION
Student Name
s Grade Date of Birth
i 12 01/31/2001
School s Date AT Plan Review Date
6/5/17 8/5/17
t
i
v
e
POINT OF CONTACT (Individual assigned to keep the Implementation Plan updated)
I
EQUIPMENT TASKS
m
TASK (e.g., order/procure AT, load software, adapt/customize devices/software, set up PERSON RESPONSIBLE DATE DUE
p
at home/school, maintain/repair, etc.)
o
n
provider, etc…)
Case Manager/Service
Parker Martin Provider
Special Education
Lavonda Tanner Department Head
General Education
Drew Wilson Teacher
Principal
Robert Wheeler
Student/Parent
Student/Parent
TRAINING
TRAINING NEED TRAINEES TRAINER DATES & TIMES FOLLOW UP / ALONG PLAN
Co: Writer Basics/ All listed Special Individuals Collaborate via email with
Troubleshooting individuals Services planning/lunc one another to follow up on
of the team Director h 1x weekly training as well as make
above for 1 month suggestions.
CLASSROOM IMPLEMENTATION
IEP GOAL CURRICULUM/DOMAIN (e.g., PERSON(S) RESPONSIBLE AT NEEDED TO ACCOMPLISH GOAL (List specific
math, science, PE, art, etc…) AT and customized settings if appropriate)
HOME IMPLEMENTATION
IEP GOAL CURRICULUM/DOMAIN (e.g., PERSON(S) RESPONSIBLE AT NEEDED TO ACCOMPLISH GOAL (List specific
math, science, PE, art, etc…) AT and customized settings if appropriate)