I, the parent or adult student identified below, have been informed that

 :

(Participating Agency)

Participating Agency Contact Information:

Name:

Phone:

Address:

Email:

may be providing or paying for certain transition services, and I have been further informed that:

It is appropriate for a representative of the above agency to attend an IEP meeting at which transition services will be discussed; and

Information in my child’s (or in my) education records, including the IEP, that is relevant to the development of postsecondary goals, transition assessments and transition services may need to be disclosed to the representative of the above agency at the IEP meeting; and this disclosure can be made only with my consent which I understand must be voluntarily given and may be revoked at any time;

Having been informed as stated above, I give my consent for the school district to do the following (check all that apply):

____ to invite a representative of the above agency to attend the IEP meeting scheduled for  ;