Form Isbe 34 41 PDF Details

In the intricate world of special education services, maintaining compliance with established guidelines for class sizes and age ranges is a cornerstone for creating an effective learning environment that can cater to the unique needs of each student. The Illinois State Board of Education (ISBE) has set specific regulations to ensure these environments are optimized for learning and growth. However, recognizing that a one-size-fits-all approach is not always feasible, the ISBE extends the option for schools to apply for deviations from the standard class size and age range requirements through the ISBE 34-41 form. This critical document, essential for the 2013-2014 school year, serves as a formal request for approval to implement such deviations. Schools are required to furnish detailed information including the rationale for the deviation, a description of the current class setup, and the measures being taken to return to compliance. Furthermore, this form encompasses sections for cooperative/district information, staff qualifications, and program details, ensuring that any deviation still aligns with the overarching goal of providing a solid and beneficial educational experience for students with special needs. The ISBE meticulously reviews these requests, underscoring the importance of adherence to guidelines while also allowing flexibility where it is justified and in the best interest of the students’ educational needs.

QuestionAnswer
Form NameForm Isbe 34 41
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other names34 41_deviation_cl ass_age isbe special education classroom size 2013 2014 school year form

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ILLINOIS STATE BOARD OF EDUCATION

Special Education Services Division

100 North First Street, N-253

Springield, Illinois 62777-0001

OR

Telephone: 217/782-5589

E-mail: CLSZAGRA@isbe.net

REQUEST FOR APPROVAL OF SPECIAL EDUCATION CLASS SIZE/AGE RANGE DEVIATION(S)

School Year 2013-2014

INSTRUCTIONS: Complete and submit this form to the above address or e-mail address. Approval must be obtained prior to the implementation of class size or age range deviations. If this is not possible, the district must provide services as closely aligned as possible to the student’s IEP while awaiting a response to the deviation request.

COOPERATIVE/DISTRICT INFORMATION

NAME OF SCHOOL

 

 

 

NAME/TITLE OF DISTRICT CONTACT PERSON

 

 

 

 

 

 

SCHOOL ADDRESS (Street, City, State, Zip Code)

 

 

SCHOOL E-MAIL ADDRESS

GRADES IN BUILDING

 

 

 

 

 

DISTRICT NAME AND NUMBER

 

 

NAME OF DIRECTOR OF SPECIAL EDUCATION

 

 

 

 

 

 

DISTRICT ADDRESS (Street, City, State, Zip Code)

 

 

TELEPHONE (Include Area Code)

FAX (Include Area Code)

 

 

 

 

 

 

 

 

 

STAFF INFORMATION

 

 

 

 

 

 

NAME OF CLASSROOM TEACHER

 

 

IEIN OR COPY OF CERTIFICATE FOR CLASSROOM TEACHER

 

 

 

 

 

NAME OF PARAPROFESSIONAL

 

 

IEIN OR COPY OF CERTIFICATE FOR PARAPROFESSIONAL

 

 

 

 

 

 

 

 

 

PROGRAM INFORMATION

 

 

 

 

 

 

PROPOSED DEVIATION

 

 

 

 

Class Size

____________

Age Range

_____________

 

RATIONALE

The rationale for this deviation must include an explanation of why the deviation is necessary and what the district is doing to correct non-compliance by the beginning of the 2014-2015 school year. Please submit all documentation relevant to the district’s self-assessment with this form.

Provide the following information regarding this deviation request. Note: Do not type beyond the allotted space provided. Attach additional sheets to this form as necessary.

YES

NO Did you request a deviation for the same class/program previously? If yes, describe the reasons for the resubmission.

Describe the direct cause for this request.

ISBE 34-41 (6/13)

Page 1 of 4

RATIONALE (CONTINUED)

Describe the proposed class size/age range of classroom.

Describe the options that were explored prior to this deviation request and why they were determined to be inappropriate.

_____________________________________________________________________

_____________________________________________________________________

Date

Original Signature of District Superintendent

Date

Original Signature of State-Approved Director

 

 

 

 

ISBE USE ONLY

Full approval will be withdrawn from approved program deviations if monitoringoftheseprogramsbytheIllinoisStateBoardofEducation

determines that they are: 1) not being implemented as approved; and/or 2) it is determined that adequate/suficient services are not

beingprovidedtothespecialeducationstudentsbasedontheirIEPs.

DATE RECEIVED

DATE DISAPPROVED

REVIEWER

POST EVALUATION DUE DATE

 

 

 

DATE APPROVED

REVIEWER

RECEIPT DATE

 

 

 

ISBE 34-41 (6/13)

Page 2 of 4

ILLINOIS STATE BOARD OF EDUCATION

Special Education Services Division

100 North First Street, N-253

Springield, Illinois 62777-0001

E-mail: CLSZAGRA@isbe.net

SPECIAL EDUCATION CLASSROOM SCHEDULE*

* Complete one for each program which has one FTE special education teacher.

NAME OF SCHOOL

SCHOOL YEAR

 

 

NAME OF TEACHER

TYPE OF SCHOOL

Elementary Pk-6

Elementary Pk-8

Middle

Junior High

Senior High

Junior/Senior High

Special Education Center

Other ________________________

CLASS

PERIOD

AGE SPAN BY BIRTHDATE OF OLDEST/

YOUNGEST CHILD

(Age Range Request Only)

 

 

 

 

CLASSROOM

 

NUMBER OF STUDENTS

 

PARAPROFESSIONAL

 

(Class Size Request Only)

 

(NOT INDIVIDUAL

 

 

 

STUDENT AIDE)

 

 

 

 

 

EE Code 1

EE Code 2

EE Code 3

Yes

No

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

ISBE 34-41 (6/13)

Page 3 of 4

ILLINOIS STATE BOARD OF EDUCATION

Special Education Services Division

100 North First Street, N-253

Springield, Illinois 62777-0001

OR

Telephone: 217/782-5589

E-mail: CLSZAGRA@isbe.net

SPECIAL EDUCATION TEACHER ASSESSMENT OVERVIEW

For conidentiality purposes, this completed form can be submitted directly to the Illinois State Board of Education at the indicated address or e-mail address.

ISBE 34-41 (6/13)