Written Notice Upon Graduation or Aging Out
Written Notice Upon Graduation or Aging Out - Word (35 KB)
To the Parents/Guardian of ___________________:
New York State Education Law requires that this notice and request for consent to release education records be provided as follows:
For students age 18 who are in residential care:
- This notice must be provided to the parent and to the student by November 1st of the school year in which the student will attain the age of 18 (or if over the age of 18 when placed, at the time of placement).
For students who receive nonresidential special education services 100 percent of the school day, have intensive management needs or a severe disability; and may need adult services:
- This notice must be provided upon the first annual review after the student attains the age of 15.
This is to provide notice that NAME OF STUDENT may require adult services when he/she is no longer eligible to receive tuition free educational services because of receipt of a high school diploma or when the student ages out of school at the end of the school year in which he/she turns age 21.
Information on how to obtain a determination of the student’s need for adult services can be accessed as follows:
Office for People With Developmental Disabilities (OPWDD)
Eligibility for OPWDD Services: Important Facts http://www.opwdd.ny.gov/wt/forms/wt_important_facts.jsp
Transmittal for Determination of Developmental Disability - Verification of an individual's qualifying developmental disability is required for determination of eligibility for OPWDD services.
If you cannot access the forms, they are available by contacting your local DDSO.
To contact OPWDD, call (866) 946-9733
New York State Office of Mental Health
1-800-597-8481 (A toll free resource for questions or complaints about mental health services in New York State.)
A description of adult services available through OMH can be found at http://www.omh.ny.gov/omhweb/adults/
Information on eligibility for these services may be obtained from the OMH field offices:
Office of Children and Family Services
For possible services offered by OCFS, see http://www.ocfs.state.ny.us/services/
INSERT DISTRICT LETTERHEAD
We are seeking your consent to provide a copy of the student’s education records to the following State agency(ies) for consideration of eligibility for adult services: _________________________.
The documents from the student’s education record to be provided are identified below:
Upon request, you may review to the information to be forwarded and you may provide us with additional relevant information that may be your possession that you wish to be included with the above documents.
These records will be shared with the above agency(ies) in accordance with the privacy rights of the Individuals with Disabilities Education Act (IDEA) and the Family Educational Rights and Privacy Act (FERPA).
Please sign below and return to the following address within 30 calendar days.
Parent / Guardian of ______________________________________ (name of student)
____________________________________________________________________________________________________________Student (if age 18 or older).
Date consent provided: ___________________________________________
Return form to:
For questions regarding this notice, you may contact ___________________________________.