Special Education

Required Documentation for Placement in an
Out-of-State Residential School or Emergency Interim Placement (EIP) - PDF PDF document(52 KB)

The information required in this section must be completed by the CSE as part of an out-of-State residential or emergency interim placement.

A.   List all NYSED-approved in-State (and/or out-of-State for EIP) private schools to which the CSE referred a student and the results of those referrals.  Attach the letters from the private schools that confirm acceptance or rejection of the student.  For reapplications, letters within six months of the date of receipt of application are acceptable.  Duplicate this page as needed.

Name of School to which Referral Packet was Sent Date of CSE Meeting Date Referred to School Date of Response from School Response (check one) Date of Acceptance/ Rejection Reason(s) for Rejection, if applicable
Accepted Rejected


B. If the CSE has determined that the private school(s) that accepted the student is unable to meet the student’s IEP needs, the CSE must provide a statement justifying its actions.  Such rejections must be based on sound educational reasons consistent with the IEP.  This information becomes part of the official CSE record.

Last Updated: March 9, 2012