Palau Ministry of Education Special Education Program
Form CLEL: Eligibility Checklist
SIS Student Id:
Student Name:
...
Form Name
Completed By and Date
SE02 - Evaluation Plan
signature:
_______________________
date:
_____________
SE03 - Parent Notice
signature:
_______________________
date:
_____________
SE04 - Parent Consent for Evaluation
signature:
_______________________
date:
_____________
SE06a - Evaluation Summary
signature:
_______________________
date:
_____________
se06e - Teacher Input/Classroom Observation
signature:
_______________________
date:
_____________
Required support document: Evaluator's Report
signature:
_______________________
date:
_____________
The support documents listed below are included
with this phase of the SpEd Process.
signature:
_______________________
date:
_____________
Support Documents List