Fillable SECTION 504 INDIVIDUALIZED ACCOMMODATION PLAN (Bureau of Indian Affairs)

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SECTION 504 INDIVIDUALIZED ACCOMMODATION PLAN (Bureau of Indian Affairs)

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SECTION 504 INDIVIDUALIZED ACCOMMODATION PLAN
Student ID/NASIS #:
Meeting Date:
Name:
Parent/Guardian 1:
Birthdate:
Parent/Guardian 2:
School:
Grade:
School Contact Person:
Position:
STUDENT AREA OF
NEED
Example: organization
ACCOMMODATION TO
ADDRESS NEED
Provide student with
agenda and sign for
accuracy daily
PERSON(S)
RESPONSIBLE
Classroom teacher
FREQUENCY and
SETTING for EACH
ACCOMMODATION
Daily at the end of each
class
Classroom
IAP CONTINUED STUDENT: _______________
DATE: ____________NASIS #_______________
NOTES:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I have participated in developing
the Individualized Accommodation
Plan (IAP) for the above named
student under Section 504.
Participant's Name
Title/Email
Participant's Signature
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SECTION 504 INDIVIDUALIZED ACCOMMODATION PLAN (Bureau of Indian Affairs)

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Completed 26 January 2021

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