504 Manifestation Determination

Enter the student’s current verified disabilities(s).

Provide a description of the behavior that resulted in disciplinary action. This section should be based on facts associated with the incident. Reference the school Policy and Conduct codes when describing the resulting disciplinary action.

Provide a summary of previous suspensions with references to school Policy and Conduct codes that were violated.

Click within the boxes to select the records and information that were reviewed as part of the manifestation determination. Other information can be entered into the text box. 

Click on the ‘Yes, No’ radio button to indicate if the conduct in question is determined to have a direct and substantial relatiohip to their disability.

Click on the ‘Yes, No’ radio button to indicate if the conduct in question is a result of the failure to implement the student’s 504 plan.

Click on the radio button indicating that the parent did or did not give consent. The can be used to clear radio button selections.

Click within the boxes to select all actions taken by the 504 team.

Once you have rows added, you can add the full name and role of the persons that will be in attendance at the meeting in the text boxes.  If you need to remove a row, click the at the end of the row and the row will delete.

Click in the box indicating the parent signature is on file. The signed date and signature box will appear.

Enter the date the parent/guardian signed the Manifestation Determination Document.

Type the parent/guardians full name.

On tab 2:  you can attach documents you want to have included with this form.  Click to prompt the upload screen and navigate to the document you want to add. Use the to remove documents you no longer want uploaded. An example would be signature pages.