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1342.12 Companion
July 12, 2017
Page 108
Summary of Performance/Final Year Transition Plan Form
GENERAL INFORMATION
Name of Student:
Date of Graduation/Exit:
Type of Diploma:
☐
Honors |
☐
Standard
Contact Person: (First, Last Name)
Title:
PART I: SUMMARY OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE
Area
Present Level of Performance
(Upon school graduation/exit)
Needs
(Essential accommodations, assistive
technology, environmental or material
resources or modifications needed)
Academic
Achievement
Functional
Performance
Learning
Characteristics
Social
Development
Physical
Development