District Approval for Alternate Course (Senior High)

Student's Name:___________________________ School:________________________

Date of Birth:___________________ Level:___________________________________

Area of or title of alternate course:_____________________________________

1. The following is in place:

a. _______ an ISSP for the student which outlines the alternate course is attached

b. _______ the parent's signature is on the ISSP

c. _______ the signature of all members of the program planning team

2. The ISSP outlines:

a. _______ the student's strengths and needs

b. _______ the goals and outcomes of the alternate course

c. _______ any specific supports and services required

d. _______ the person(s) responsible for teaching the alternate course

e. _______ the environment(s) in which the course will be delivered

3. The course as described in the ISSP:

a. _______ is in an academic area

                or

_______ is outside of the academic domain

b. _______ reflects modification of a "regular" prescribed course and therefore is more suited to
"modified courses" than "alternate courses"

                or

            _______ is an alternate course as described in the guidelines

                or

            _______ is part of an alternate curriculum, in which case the student is ineligible

4. In addition to this alternate course, is registered for:

a. _____ all "regular" courses without support ( Pathway 1 )

b. _____ "regular" courses with support ( Pathways 2)

c. _____ mainly "modified" courses ( Pathway 3 )

d. _____ some other "alternate" courses ( Pathway 4 ) along with "regular" or "modified" courses

e. _____ an "alternate curriculum" ( Pathway 5 ) - NOTE: students who meet "Criteria C" and are on an alternate curriculum are not eligible for course credit

f. _____ other: _____________________________________

5. The alternate course is approved: ______Yes ______ No

_________________________________        ______________________________

Coordinator for Student Support Services           Other district personnel (as necessary)

_________________________________

Assistant Superintendent/Superintendent

Date___________________________

Complete form to be returned to the Department of Education

before the 15th of January when all student registration is forwarded First 'B' entry