ADR Support Request/ Solicitud de soporte ADR

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The purpose of this form is to connect you with a specialist who can support your Alternative Dispute Resolution request.

El propósito de este formulario es conectarlo con un especialista que pueda respaldar su solicitud de Resolución alternativa de disputas.

Email *

Your Name (first and last name)

Su nombre (nombre y apellido)

Coreo Electronico

Telephone Nmber

Numero de Telefono

I am a

Soy

Student Name

Nombre del estudiante

Student Date of Birth

Fecha de nacimiento del estudiante

YYYY

School Site the student attends

El escuela de su Estudiante

Concern is in reference to

Cual es su preocupacion

IEP Concern (disagreement with parts of the IEP)

Evaluation (Evaluacion)

Identification (Identificacion)

Placement/Services (Servicios y programacion)

Other Special Education Support (Otros servicios de educacion espescial)

Other:

Required

I am seeking to have a...

Busco tener un...

Do you need a translator?

Necesitas traductor/ traductora

Yes/Si

Other

Other:

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