SECONDARY SCHOOL SUMMARY OF PERFORMANCE

This form is used to:

1. Comply with the new requirements for a “Summary of Performance” in IDEA 2004, Sec. 614 (c) (5) (B) (ii).

                     The Summary of Performance:

                     a.     Provides information to students who will be graduating with a regular diploma to assist them in
                             meeting their post-secondary goals; and

                     b.     Provides information to students who will be graduating / leaving school because they exceed
                             age of eligibility for a free appropriate public education, to assist them in meeting their post-

                             secondary goals.

                     c.     It is suggested that for students exiting school at the end of their entitlement for reasons other

                             than receiving a regular high school diploma, school districts may provide a Summary of   
                             Performance for these students also.

Prior to completing the Summary of Performance, you may want to consider engaging the student for the purpose of receiving input on the student’s perspective. (Optional)

Directions:

1. Enter student’s name and birth date.

2. Enter attending school.

§     Please be aware a release of information must be signed prior to speaking with another  
       person/agency.

3. Enter anticipated regular high school graduation date.  The exit date should be the same as the exit date information on the student’s IEP.

4. Write a summary of the student’s academic achievement.  This statement may include:

§ How the student’s disability has affected the student’s academic achievement.

§ The student’s academic strengths as outlined in her/his IEP.

§ The results of the most recent special education evaluations of the student.

§ You may include additional academic performance information that maybe essential to postsecondary outcomes for the areas:

o reading

o math

5. Write a summary of the student’s functional performance.  This statement may include:

§ How the student’s ability has affected the student’s functional performance.

§ A description of any known work experience (paid or unpaid).

§ A description of any other recognition the student earned in high school,

o any honors or special education awards the student achieved,

o    any vocational or extracurricular accomplishments.

§ You may include additional functional performance information that maybe essential to postsecondary outcomes such as

o executive functioning

o personal management

§ communication

§ ADL skills

§ serial skills

§ independent living

§ self advocacy

6. Attach the student’s post-secondary goals form the student’s most current IEP transition plan (optional).

7. Write any recommendations for assisting the student in meeting the student’s post-secondary goals after the student exits from K-12 education.  These recommendations may include:

§ Recommendations for accommodating the student’s disability in the workplace, post-secondary education setting, and community participation,

§ Recommendations for assisting the student to achieve the student’s post-secondary goals.

          8.   Enter the name of the person completing the summary, a contact at the school level including telephone
                number, and the date of completion.

          9.  Attach any relevant supporting documents (optional).