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Sonoma County SELMA EXTENDED SCHOOL YEAR (ESY) ELIGIBILITY WORKSHEET Page 1 Student Name Date of Birth / / IEP Date / / Age Grade Gender Decisions ESY Extended School Year services are programs and
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How to fill out extended school year esy

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How to fill out extended school year esy:

01
Gather all necessary documents and forms. This may include consent forms, medical records, IEP goals and objectives, and progress reports.
02
Review the specific guidelines and instructions provided by the school or district regarding the esy application process. Pay close attention to deadlines and any required documentation.
03
Fill out the application form accurately, providing all requested information. This may include details about the student, such as their name, date of birth, grade level, and current school.
04
Clearly indicate the reasons why the student requires extended school year services. This should be based on the student's individual needs and documented in the most recent IEP. Provide specific information about any regression or substantial inability to recoup skills after breaks from instruction.
05
If applicable, include any relevant medical or diagnostic reports that support the need for extended school year services. This could include information regarding the student's diagnosis, therapies received, and recommendations from healthcare professionals.
06
Collaborate with the student's IEP team, including teachers, therapists, and administrators, to ensure all necessary information is included in the application form.
07
Submit the completed application form and supporting documents by the specified deadline. It is recommended to keep copies of all submitted materials for your records.

Who needs extended school year esy:

01
Students with disabilities who require additional instructional support to maintain or improve their skills during extended breaks from school, such as summer vacations.
02
Students who show significant regression in their academic or functional skills following shorter breaks from school, indicating a need for continuous instruction.
03
Students whose IEP teams determine that extended school year services are necessary to help the student achieve their educational goals and make progress towards their IEP objectives.
04
Students who have complex needs and require a more intensive and individualized educational program, which cannot be fully addressed during the typical school year.
05
Students who may have experienced disruptions in their learning due to factors such as frequent absences, transitions, or changes in educational settings.
06
Students who have specific transition goals outlined in their IEP that require additional support and instruction during extended breaks, in order to ensure a smooth transition to the next grade level or post-school settings.
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