Moore County Schools Exceptional Education Program

Surrogate Parent

Student Name: ______Date Of Birth: ______

Date: ______

Dear ______

Thank you for your participation as a Moore County School’s Exceptional Education surrogate parent. This letter certifies that you have participated in the surrogate parent training and confirms your appointment in this role under the Exceptional Children’s Program. As a surrogate parent, you will represent the above named child in all Exceptional Education matters related to:

·  Providing all necessary consents such as consent for evaluation or service delivery and authorization for release of information;

·  Evaluations and assessments, including being present and contributing as appropriate;

·  The development, implementation, and signing of the Individualized Education Plan (IEP), including all reviews and annual meetings; and

·  The ongoing provision of free and appropriate public education (FAPE) that includes Exceptional Education supports and services.

A surrogate parent is considered to be the parent and is afforded all rights given to parents and their children under the Individuals with Disabilities Act (IDEA) and federal and state guidelines for Exceptional Education (EC) Programs. A surrogate parent is appointed specifically to protect the educational rights of the child, but is not legally liable for actions taken in good faith to protect these rights on behalf of the child. All information shared with the surrogate is strictly confidential and is to be solely for the purpose of the child’s educational planning. The role of surrogate parent does not require you to be responsible for the care, maintenance or financial support of the child. As a surrogate parent you do not have the authority to act on behalf of the child outside of the Exceptional Children’s Program.

Your signature below certifies that you accept the surrogate role and that you have received a copy of the Procedural Safeguards (Parent Right’s Handbook).

Sincerely,

(Moore County Schools EC Program Specialist or Designee)

(Surrogate Parent Signature)