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_____________________

_____________________

Parent/student name & address

_______________ ____, 20____

___________________________

___________________________

___________________________

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Educational Diagnostician, Principal or Director of Special Education

Name & address

To Whom It May Concern:

I/My child, _____________________________________, has an I.E.P. pursuant to the Individuals with Disabilities Education Act. I am requesting that you convene an I.E.P. meeting to discuss some concerns that I have. Specifically, I would like the I.E.P. meeting to address the following topic(s):

1.___________________________________________________________________

____________________________________________________________________

____________________________________________________________________

2.______________________________________________________________

_______________________________________________________________

_______________________________________________________________

3.______________________________________________________________

_______________________________________________________________

_______________________________________________________________

4.______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Please contact me at ___________________________ if you have any questions, need additional information, or to select a mutually agreeable date. Thank you.

Sincerely,

_____________________

Student/Parent/Guardian