250 | ocali.org/center/family
Appendix D
Date you write your letter
(Include month, day and year)
Your Name
Your Full Address
Full Name of Person to whom you are writing
(the Principal or the Special Education
Director)
Person’s Title
(Principal, Special Education Director)
Name of School
Full Address of School
Dear
(Use their title [Dr.; Mr.; Mrs.; Ms.] and last name):
I am the parent of
(Your child’s name)
, who is in the ____ grade at
(Name of school).
My
child is not performing successfully in the general education classroom.
(Briefly state your
concerns; examples: failing grades; problems with friends at school; it takes a very long
time for your child to complete homework; child comes home very upset; etc.)
Under Ohio Administrative Code 3301-35-06, the general education teacher is required to do
interventions to assist in my child’s success. Since my child is still not performing successfully,
I suspect he/she a disability. Under Child Find §300.125 in IDEA ‘97, I am requesting a
complete Multi-Factored Evaluation.
Please consider my signature on this letter as my permission to test my child. It is my
understanding that when a Multi-Factored Evaluation is requested, the school district is
required to provide parents with their procedural safeguards. Please forward them to me at the
above address.
Thank you for your attention to my request. I may be reached at
(Your daytime phone
number).
I will expect to hear from you within 5 school days of receipt of this letter.
Sincerely yours,
Your Full Name
