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PD 5 FORM CONTENTS:

Transmittal Letter

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Instructions and Definitions

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Section A

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Section B

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Section C

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Official Seal of the New York State Education Department THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234
_____________________________________________________________________________________________________
MANAGER, STRATEGIC EVALUATION DATA COLLECTION, ANALYSIS AND REPORTING
1613 ONE COMMERCE PLAZA
ALBANY, NEW YORK  12234
Tel. (518) 486-4678
Fax (518) 408-3363
 E-mail:  dataquest@mail.nysed.gov  

 

To: Special Education Data Managers and Chief School Officers of:

Public School Districts
Special Act School Districts
Approved In-State Private Schools that Provide Special Education   Pursuant to Article 81 of the Education Law.
Selected State-Agencies

September 2004
From: Inni Barone
Subject:

PD-5 - Report of Students with Disabilities: Sections A and B--Exiting Special Education and Section C--Postsecondary Education and Employment Plans, July 1, 2004 to June 30, 2005.

Important: Due Date is Between July 1, 2005 and August 12, 2005. All school districts and other programs required to submit this report must submit it electronically through the PD web-based system at http://pd.nysed.gov or through the File Transfer Protocol (FTP) process. Paper copies of this report will not be accepted.

Attached is a PD-5 form for reporting declassification, exiting and postsecondary education and employment plans data for all students with disabilities (ages 3-21) who are the responsibility of your school district's/agency's Committee on Preschool Special Education (CPSE) or Committee on Special Education (CSE), during the period July 1, 2004 to June 30, 2005. For preschool students with disabilities, ages 3-4, and for school-age students with disabilities, ages 4-13, only declassification data are required. For students with disabilities, ages 14-21, data for all basis of exiting as well as data on postsecondary education and employment plans are required. Please note that Special Act School Districts and approved private schools located within New York State that provide educational services to students with disabilities pursuant to Article 81 of the Education Law as well as to students pursuant to a contract with public school districts, should complete the PD-5 report for students provided services pursuant to Article 81 only. In addition, such programs must report exiting and postsecondary education plans data for all students (contracts with school districts and students provided services pursuant to Article 81) in the PD-5B report. New York State Education Department (SED) is required to submit these data to the United States Department of Education Pursuant to Section 618(b) of Public Law 101-476.

A User ID and password to access the PD web-based system has been mailed to the contact person identified on your latest PD-1/4, PD-2A/4 or PD-3A/4 report. If your school has a new contact person, or did not get this information, please contact our office. Please note, if your school district has the capability of submitting PD-5 data through the FTP process, the User Name and password for that process are different from the User ID and password that has been assigned to the contact person to submit PD data through the web-based system. If your school district needs a User Name and password to submit data through the FTP process, please contact this office. The due date for this report is between July 1, 2005 and August 12, 2005. Paper copies of this report will not be accepted. Your timely and accurate completion of this report is required in order to ensure full compliance with federal reporting requirements.

Compared to the PD-5 form for 2003-2004, the 2004-2005, PD-5 has been revised in the following ways:

For the 2004-2005 school year, SED will analyze exiting and post secondary plans data submitted by school districts through the STEP reporting system and the PD-5 reporting system. If it is determined that data from the STEP reporting system will meet federal and State reporting requirements, the separate data collected through the PD-5 report will be discontinued for the 2005-06 and subsequent school years. The Department is moving towards an individual student level data collection system and will eventually discontinue collecting aggregated data. For this reason, special education personnel should collaborate with appropriate school district personnel (school district STEP coordinator) to ensure the same data are submitted through both PD-5 and the STEP reporting systems for the 2004-05 school year. If you have any questions regarding reporting consistent data for students with disabilities through both systems, please contact the Strategic Evaluation Data Collection, Analysis and Reporting (SEDCAR) Unit.

During 2004-2005, SEDCAR personnel may be available to conduct a limited number of regional training programs regarding the special education data collected through the PD forms. If you feel that such training would be useful to the data managers in your area, please contact your local Special Education Training and Resource Center (SETRC). The data collected through the PD forms are used in one or more of the following reports and activities:

  • Annual Performance Report For Special Education

  • Pocketbook of Goals and Results for Individuals with Disabilities

  • Chapter 655 Report to the Governor and the Legislature on the Status of the State’s Schools

  • Special Education Quality Assurance Reviews

  • School Report Cards

  • BOCES Report Cards

  • Charter School Report Cards

  • Calculations to identify instances of possible race/ethnicity disproportionality

  • Other reports required by State or federal statutes

  • Summary reports for public information to be placed on the Department’s website

  • Evaluation of programs and policies

  • If you have any questions or are in need of assistance in completing this report, please contact the SEDCAR Unit by using the contact information provided in the letterhead. Thank you.

    Attachment

    cc: Rebecca H. Cort


    The University of the State of New York
    THE STATE EDUCATION DEPARTMENT
    Office of Vocational and Educational Services for Individuals with Disabilities (VESID)
    Strategic Evaluation Data Collection, Analysis and Reporting
    One Commerce Plaza - Room 1613 — Albany, NY 12234-0001

    PD-5 - Report of Students with Disabilities:
    Sections A and B: Exiting Special Education
    Section C: Post Secondary Education and Employment Plans
    July 1, 2004 to June 30, 2005

    Instructions:

    1. Please submit these data electronically at http://pd.nysed.gov or through the FTP process between July 1, 2005 and August 12, 2005. Paper copies of this report will not be accepted.

    1. Retain one copy (and supporting documentation) in your district/agency for reference and audit purposes. The required retention period ends June 30, 2011.

    1. Carefully read the Instructions and Definitions on the following pages.

    1. If you have questions about this report, please call (518) 486-4678, or e-mail your questions to dataquest@mail.nysed.gov

     

     

     

    Check this box if no students exited special education (including students declassified) between the ages of 3 and 21 within the report period. If this box is checked, and you have submitted this information through our website at http://pd.nysed.gov your report is complete.

    District/School/Agency Information

    (Enter 12-digit SED Code Below)

                           
    DISTRICT/SCHOOL/AGENCY NAME

     

    ADDRESS (include building name, room number, or mail stop information)


     

    CITY STATE ZIP

    Contact Person Information*

    NAME
    TITLE
    TELEPHONE (Include Area Code) FAX
    E-MAIL ADDRESS

    *All correspondence from the address at the top of this page will be directed to the contact person reported in the PD web-based system at http://pd.nysed.gov.  You may update the contact person at any time through the PD web-based system located at http://pd.nysed.gov.


    Definitions and Instructions for Completing the PD-5 Report

    1. Report information for all students with disabilities (ages 3-21) who were the responsibility of your CPSE or CSE. For public school districts, this includes students who are provided special education in approved private schools, other public school districts, BOCES, State-Operated and State-Supported Schools, and Charter Schools. Public school districts should also include data for students with disabilities who resided in the district at the time they were placed in out-of-State approved residential schools by the courts or other agencies. In Sections A and B, report the number who exited special education through the basis listed. In Section C, report the postsecondary education and employment plans of students with disabilities by the basis of exiting. Please note that Special Act School Districts and other approved private schools that are located within New York State and provide special education services for students with disabilities pursuant to Article 81 and through contracting with public school districts should complete the PD-5 report for students with disabilities that are provided special education pursuant to Article 81 only. In addition, these schools must also complete a PD-5B report for students provided special education pursuant to Article 81 and through contracting with public school districts.

    2. Wherever data is requested by student age, the age should be reported as of December 1, 2004 (e.g., a student who is 14 years and 10 months of age on December 1, 2004, should be reported as age 14).

    3. Students with disabilities’ race/ethnicity must be reported consistently on all PD forms and other Department data collection instruments. Each student must be reported in only one of the race/ethnicity categories described below. We recommend the parents be provided an opportunity to designate their children as belonging to the one category. If they are unable to choose among the categories, school district personnel must use their best judgement and report the student in the category based on the group to which the student appears to belong, identifies with, or is regarded in the community as belonging.
      American Indian/Alaskan Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
      Asian or Pacific Islander: A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. The Pacific Islands include Hawaii, Guam, and Samoa.
      Black or African American (not Hispanic): A person having origins in any of the Black racial groups of Africa.
      Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
      White (not Hispanic): A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

    4. On pages 5-18 of the report, the totals for Age (Column I), Gender (Columns K and L), and Race/Ethnicity (Columns M-Q) must be equal.

    5. In general, exiting students with disabilities should be reported once, with few exceptions; as provided in the following examples:

    • A student who is declassified and returned to general education several times, should be reported once each year that he or she is returned to general education, on pages 4-18.

    • A student who receives a local diploma with a Regents endorsement should be reported in either Line 1 (Regents Diploma-Honors) or Line 2 (Regents Diploma-Regular) on pages 5-18.

    • A student, who previously received an IEP diploma, has continued in the special education program and does not receive a higher diploma should NOT be counted again.

    • A student who previously received an IEP diploma, has continued in their special education program and receives a Regents, local or High School Equivalency diploma, should be included in the count for the given diploma (Lines 1-4) on pages 5-18. A student who previously dropped out of school, re-enters school or some other State agency program, and receives a diploma from this school district should be reported in the count for the given diploma (Lines 1-6) on pages 5-18. If, however, the same student drops out again, in a different school year, without receiving a diploma or certificate, the student should not be reported again.

    1. If you have any questions or are in need of assistance in completing this report, please contact the SEDCAR Unit by telephoning (518) 486-4678, or e-mail your questions to dataquest@mail.nysed.gov

    Sections A and B Instructions and Definitions

    Item

    Definition

    Declassified While Still of Preschool-age.
    (Section A, Column A)
    Report the total only of all preschool-age students who were declassified by a Committee on Preschool Special Education during July 1, 2004 - June 30, 2005. These declassified preschool-age students are not age eligible to enroll in kindergarten programs during the 2005-2006 school year.
    Enrolled in General Education Without a Disability Classification After Transitioning from Preschool Special Education to School-age Programs (Section A, Column B) Report the total only of all students who received preschool special education services pursuant to Section 4410 or 4201 of the Education Law just prior to becoming school-age and were either not referred to CSE for school-age special education or if referred were determined to be ineligible for school-age special education services. Report students in this column if they were declassified by May or June 2005, and were not provided preschool services during July and August preceding their entrance into school-age programs. Declassification data for preschool students who were provided special education services during July and August 2005 should be reported in next year's PD-5 report.

    Column J – CTE Credential
    Section B, Reports 1-14

    CTE Technical Endorsement: Report the number of students with disabilities who earned a Local or Regents diploma with a Career and Technical Education (CTE) Technical endorsement. Requirements for earning a CTE Technical endorsement may be found in 8NYCRR 100.5

    Career and Technical Education (CTE) Skills Achievement Profile: Report the number of students with disabilities who received an Individualized Education Program (IEP) Diploma or Local Certificate, who participated in a Career and Technical Education program, and received a CTE Skills Achievement Profile. See information about this credential at http://www.p12.nysed.gov/workforce/cteskillsachievementprofile/home.html

    Regents Diploma (Honors)
    (Section B, Line 1 on pages 5-18)
    Students who received a local high school diploma with the Regents endorsement "With Honors."
    Regents Diploma (Regular)
    (Section B, Line 2 on pages 5-18)
    Students who received a local high school diploma with a "Regular" Regents endorsement (8 NYCRR 100.5).
    Local Diploma
    (Section B, Line 3 on pages 5-18)
    Students who received a local high school diploma without a Regents endorsement (8 NYCRR 100.5).
    High School Equivalency Diploma (Section B, Line 4 on pages 5-18) Students who received a State High School Equivalency Diploma who were dually enrolled in a secondary education and an Alternative High School Equivalency Preparation Program or a High School Equivalency Preparation Program (8NYCRR 100.7). These Diplomas are also referred to as GED Diplomas.
    Individualized Education Program Diploma (Section B, Line 5 on pages 5-18) Students who received a High School Individualized Education Program Diploma (8 NYCRR 100.9).
    Local Certificate (Section B, Line 6 on pages 5-18) Students who received a Local Certificate (8 NYCRR 100.6). These certificates may not be issued after February 1, 2005.
    Declassified and Returned to General Education
    (Section A, Columns C & D and Section B, Line 7 on pages 5-18)
    Students who were classified by the CSE due to a disability and received special education between July 1, 2004 - June 30, 2005, and are declassified between July 1, 2004 - June 30, 2005 and returned to general education. These students no longer have an IEP and receive all educational services from a general education program including testing accommodations if indicated on the last IEP as recommended upon declassification. Report students who were declassified during this time period, even though they will begin general education programs during the next time period. If the student is receiving "declassification support services", the student should be reported declassified only in the year in which declassification occurred. If the student is getting "transitional support services", the student has not been declassified, so should not be reported as declassified.
    Reached Maximum Age
    (Section B, Line 8 on pages 5-18)
    Students who were enrolled in school at the age of 21 (turned 21 after September 1, 2004, and who did not receive a diploma or certificate or exit special education by any other basis of exiting.)
    Died (Section B, Line 9 on pages 5-18) Report the number of students who died during this report period.
    Moved - Known To Be Continuing
    (Section B, Line 10 on pages 5-18)

    Students who moved out of the school district's catchment area, or left the State agency program and are known to be continuing in another educational program. A student should be reported here if another school district or program has requested a transcript or if the school has other documentation indicating students’ continuing enrollment. There need not be evidence that such students are continuing in special education, only that they are continuing in another educational program. This line includes students who are placed in Child Care Institutions by the courts or social service agencies. In the absence of any documentation, the student should be reported in Line 11, Dropped Out.

    Dropped Out (Section B, Line 11 on pages 5-18)

    Students who were enrolled at some point in the reporting year, were not enrolled at the end of the reporting year, and did not exit through any of the other basis described (lines 1-10 on pages 5-18). This line includes dropouts, moved, not known to be continuing, runaways, expulsions, status unknown, and other students who left school. Dropouts at ages 14 and 15 should only be reported after all attempts to enforce attendance requirements have failed.

    Total (Section B, Line 12, Column I on pages 5-18)

    This total should represent all students (age 14-21) who exited.

    Section A, Table 1

    Report of Students with Disabilities Exiting Special Education Between Ages 3-13
    July 1, 2004 to June 30, 2005

       

    A

    B

    C

    D

    Line No.

    Disability Category

    PRESCHOOL
    Declassified While Still of Preschool-age
    (Ages 3-4)

     

    PRESCHOOL to SCHOOL-AGE TRANSITION Enrolled in General Education Without a Disability Classification After Transitioning from Preschool Special Education to School-Age Programs

    SCHOOL-AGE

    Declassified and Returned to General Education Between Ages 4-8

     

    SCHOOL-AGE

    Declassified and Returned to General Education Between Ages 9-13

     

    1 Autism        
    2 Emotional Disturbance        
    3 Learning Disability        
    4 Mental Retardation        
    5 Deafness        
    6 Hearing Impairment        
    7 Speech or Language Impairment        
    8 Visual Impairment (includes Blindness)        
    9 Orthopedic Impairment        
    10 Other Health Impairment        
    11 Multiple Disabilities        
    12 Deaf –Blindness        
    13 Traumatic Brain Injury        
    14 Preschool Students with a Disability        
    15 Column Totals        

    Section B

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 1: Report of Students with Autism

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    Note: The totals for Age, Gender, and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 2: Report of Students with Emotional Disturbance

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 3: Report of Students with Learning Disabilities

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 4: Report of Students with Mental Retardation

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 5: Report of Students with Deafness

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 6: Report of Students with Hearing Impairments

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 7: Report of Students with Speech or Language Impairments

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 8: Report of Students with Visual Impairments (includes Blindness)

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 9: Report of Students with Orthopedic Impairments

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 10: Report of Students with Other Health Impairments

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 11: Report of Students with Multiple Disabilities

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 12: Report of Students with Deaf-Blindness

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 13: Report of Students with Traumatic Brain Injury

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.


    Section B (continued)

    Report of Students with Disabilities Exiting Special Education
    July 1, 2004 to June 30, 2005

    Report 14: Summary Report of All Disabilities*

    A B C D E F G H I J K L M N O P Q

    AGE as of December 1, 2004

    Total (A-H)

    CTE Credential

    Gender

    Race/Ethnicity

    Basis of Exit

    14

    15

    16

    17

    18

    19

    20

    21

    Male

    Female

    Amer. Ind. Alas. Nat.

    Asian/Pac.
    Islander

    Black

    Hispanic

    White

    1

    Regents Diploma (Honors)    

    2

    Regents Diploma (Regular)    

    3

    Local Diploma    

    4

    High School Equivalency Diploma (Also referred to as GED Diploma)                                  

    5

    Individualized Education Program Diploma                                  

    6

    Local Certificate    

    7

    Declassified Returned To General Education                                  
    8 Reached Maximum Age                                  

    9

    Died                                  

    10

    Moved – Known To Be Continuing

    11

    Dropped Out                                  

    12

    Total – Lines 1-11

    NOTE: The totals for Age, Gender and Race/Ethnicity must be equal.

    *The number reported in each cell of this table must represent the cumulative total of all the corresponding cells in reports 1-13.


    Section C - Report of Students with Disabilities
    Postsecondary Education and Employment Plans
    2004-2005

    Instructions:
    For all disability categories (classifications) of students with disabilities reported in Section B, Report 14, indicate their intended postsecondary plans. (School districts/programs are not required to verify that such plans were actually achieved/implemented by students.) Students should be reported once by their primary plan. (Students intending to enter postsecondary education programs and employment should be reported in the appropriate postsecondary education category.) The total number of students entered in this section should be equal to the total number of students in Section B, Report 14 who exited with a Regents Diploma (Honors), Regents Diploma (Regular), Local Diploma, High School Equivalency Diploma, Individualized Education Program Diploma, Local Certificate, Reached Maximum Age, or Dropped Out.

    Number to Postsecondary Education

    Number To Employ-ment* Number To Military Service Number To Adult Services Other Unknown Total Guidelines for Matching Numbers Reported on Page 18 of Section B
      4-Year
    College
    2-Year
    College
    Other
    Post-Secondary
    Regents Diploma with Honors                   The total number must equal the total reported on Line 1 of Page 18
    Regents Diploma (Regular)                   The total number must equal the total reported on Line 2 of Page 18
    Local Diploma                   The total number must equal the total reported on Line 3 of Page 18
    HSE Diploma (Also referred to as GED Diploma) The total number must equal the total reported on Line 4 of Page 18
    IEP Diploma                   The total number must equal the total reported on Line 5 of Page 18
    Local Certificate                   The total number must equal the total reported on Line 6 of page 18
    Reached Maximum Age                   The total number must equal the total reported on Line 8 of Page 18
    Dropped Out                   The total number must equal the total reported on Line 11 of Page 18
    Total                    

    *Employment can include regular competitive employment, or supported employment, or sheltered employment as long as the student will receive some compensation for work.

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