Page 1 of 4

TABLE4

REPORTOFCHILDRENWITHDISABILITIESEXITING

SPECIALEDUCATION

July 1, 2005 - June 30, 2006

PaperworkBurdenStatement

AccordingtothePaperworkReductionActof1995,nopersonsarerequiredtorespondtoacollectionofinformationunlessitdisplaysavalidOMBcontrolnumber. ThevalidOMBcontrolnumberforthisinformationcollectionis1820-0521. Thetimerequiredtocompletethisinformationcollectionisestimatedtoaverage7hoursperSEAand2.5hoursperLEAresponse,includingthetimetoreviewinstructions,searchexistingdataresources,gatherthedataneeded,andcompleteandreviewtheinformationcollection. Ifyouhaveanycommentsconcerningtheaccuracyofthetimeestimate(s)orsuggestionsforimprovingthisform,pleasewriteto: U.S.DepartmentofEducation,Washington,D.C. 20202.Ifyouhavecommentsorconcernsregardingthestatusofyourindividualsubmissionofthisform,writedirectlyto: OfficeofSpecialEducationPrograms,U.S.DepartmentofEducation,400MarylandAvenue,SW,Washington,D.C. 20202.

Authorization:20U.S.C.1418(a)(1)(A)(v)and1418(a)(2)

DueDate:November1,2006

SamplingAllowed:Yes

SendFormto:Troy Justesen,Acting Director

OfficeofSpecialEducationPrograms

U.S.DepartmentofEducation

ProgramSupportServicesGroup

MailStop2642

400MarylandAvenue,SW

Washington,D.C.20202

Attn:CherylBroady

GeneralInstructions

ProvideacountofthenumberofchildrenwithdisabilitiesreportedunderIDEA,PartBwhoexitedspecialeducationbetween July 1, 2005 and June 30, 2006. Dataaretobeprovidedbyage,disabilitycategory,basisofexit,andrace/ethnicity. Include only children who were in special education at the start of the reporting period, but were not in special education at the end of the reporting period. Alldataprovidedmustsum,asanunduplicatedcount,toSectionBofthetablewhereyoureportthetotalforalldisabilities. Theageofthestudentshouldreflecthis/herageinyearsonthedateofthemostrecentchildcountpriortothechild’sexiting,notattimeofexit.

SamplingGuidelines

Statesmayusesamplingtoobtainthesedata. Whensamplingisused,adescriptionofthesamplingmethodology,includingastatementabouthowthedesignwillyieldvalidandreliableestimatesthatmustbesubmittedtoOSEPforapproval. Thelevelofprecisionoftheestimatestobeobtainedmustbespecified. StatesmustsubmitsamplingplanstoOSEPforapprovalbySeptember1ofthereportingschool year(thatis,theSeptemberpriortothestart of the data collection period).

OSEPwillevaluatethevalidityofthesamplingplansusingtheguidelinesbelow.

1.Thesamplingframeworkmayincludeallschooldistrictsorasampleofdistricts. IfaStatechoosestosampledistricts,alldistrictswithaveragedailymemberships(ADM)ofover50,000mustbeincludedinthesample. Stateswithfewerthan25districtswithADMsover25,000mustincludealldistrictswithover25,000ADMs. Thetotalnumberofdistrictssampledmustequalorexceed100. IfthetotalnumberofdistrictsintheStateis100orfewer,datamustbecollectedfromalldistricts.

2.Whensamplingstudents,whetherforalldistrictsorforasampleofdistricts,datamustbecollectedseparatelyforeachFederaldisabilitycategory. Allstudentswhosedomicileisinadistrictmustbeeligibleforthesampleincludingthosestudentsservedincooperativesand/orintermediateunitsorinresidentialprogramsoutofthedistrict.

3.Aminimumsampleof100childrenineachdisabilitycategorymustbeusedbyalldistricts,exceptwherethetotalnumberinadisabilitycategoryislessthan100. Insuchacase,datamustbecollectedforallstudentsinthatcategory.

StatesthatusesamplingwillprovideOSEPwithweightedratherthanunweighteddata. Adescriptionofthefinalsamplesizesandtheweightsusedshouldalsobeprovidedatthetimethedataareprovided.

SpecificInstructions

SectionsA-C

Inthesetables,enteranunduplicatedcountofallchildrenwithdisabilities,byagecategoryanddisability,whowereinspecialeducationatthestartofthereporting period,butwerenotinspecialeducationattheendofthereportingperiod. Statesmustusea12-monthintervalforreportingexitingdatafrom July 1,2005 to June 30, 2006. Placezeros(0)incategorieswherenochildrenhaveexitedtheprogram. Enter(-9)forcategoriesnotusedbytheState.

RowA.Transferred to regular education. Totalwhowereservedinspecialeducationatthestart of the reportingperiod,butatsomepointduringthat12-monthperiod,returnedtoregulareducation. ThesearestudentswhonolongerhaveanIEPandarereceivingalloftheireducationalservicesfromaregulareducationprogram.

RowB.Graduatedwithregularhighschooldiploma. Totalwhoexitedaneducationalprogramthroughreceiptofahighschooldiplomaidenticaltothatforwhichstudentswithoutdisabilitiesareeligible. Thesearestudentswhometthesamestandardsforgraduationasthoseforstudentswithoutdisabilities.

RowC.Receivedacertificate. Totalwhoexitedaneducationalprogramandreceivedacertificateofcompletion,modifieddiploma,orsomesimilardocument. Thisincludesstudentswhoreceivedahighschooldiploma,butdidnotmeetthesamestandardsforgraduationasthoseforstudentswithoutdisabilities. IfyourStatedoesnotusecertificates,enter-9intheappropriatecells.

RowD.Reachedmaximumage. Totalwhoexitedspecialeducationbecauseofreachingthemaximumageforreceiptofspecialeducationservices,includingstudentswithdisabilitieswhoreachedthemaximumageanddidnotreceiveadiploma.

RowE.Died. Totalwhodied. Breakoutsbyageareoptionalforstudentswhodied.

RowF.Moved,knowntobecontinuing. TotalwhomovedoutofthecatchmentareaorotherwisetransferredtoanotherdistrictandareKNOWNtobecontinuinginaneducationalprogram. Thereneednotbeevidencethatthestudentiscontinuinginspecialeducation,onlythathe/sheiscontinuinginaneducationprogram. Thisrowincludescountsofandstudentsinresidentialdrug/alcoholrehabilitationcenters,correctionalfacilities,orcharterschoolsifthosefacilitiesoperateasseparatedistricts,excludingnormalmatriculation.

RowG.Droppedout. Totalwhowereenrolledatthe start of the reportingperiod,werenotenrolledattheendofthereportingperiod,anddidnotexitspecialeducationthroughanyoftheotherbasesdescribed. Thisrowincludesdropouts,runaways,GEDrecipients,[1]expulsions,statusunknown,studentswhomovedandarenotknowntobecontinuinginanothereducationalprogram,andotherexitersfromspecialeducation.

RowH.Totalofrows(A)-(G).

SectionA

Reportthenumberofstudentsages14-21thatexitedspecialeducationbyage-year,disabilitycategory,andbasisofexit.

SectionB

Reportthetotalnumberofstudentsages14-21thatexitedspecialeducationbyage-yearandbasisofexit. ThesefiguresmustequalthesumofthedatareportedinSectionA.

SectionC

Reportthetotalnumberofstudentsages14-21thatexitedspecialeducationbyrace/ethnicityandbasisofexit. ThesefiguresmustequalthetotaldatareportedinSectionB.

In November 1997, OMB announced its decision concerning the revision of Race and Ethnic Standards for Federal Statistics and Administrative Reporting. In that announcement, OMB reported that there would be five racial categories -- American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White -- and one ethnic category -- Hispanic or Latino. Additionally, OMB announced that individuals would be allowed to select as many race/ethnicity categories as were applicable. Under the new reporting requirements a single, multi-racial category cannot be used. OSEP is actively working with other offices within the Department of Education (ED) to determine what categories will be used for reporting aggregated data and anticipates that final decisions on reporting these data will be made soon. Until aggregate reporting categories are implemented, data should be reported using the five racial categories described below.

Race/ethnicitycategoriesaredefinedasfollows:

AmericanIndianorAlaskaNative / ApersonhavingoriginsinanyoftheoriginalpeoplesofNorthandSouthAmerica(includingCentralAmerica)andwhomaintainstribalaffiliationorcommunityattachment.
AsianorPacificIslander / ApersonhavingoriginsinanyoftheoriginalpeoplesoftheFarEast,SoutheastAsia,theIndiansubcontinent,orthePacificIslands. This includes,forexample,Cambodia,China,India,Japan,Korea,Malaysia,Pakistan,thePhilippineIslands,Thailand,Vietnam, Hawaii,Guam,andSamoa.
Black(notHispanic) / ApersonhavingoriginsinanyoftheBlackracialgroupsofAfrica.
Hispanic / ApersonofMexican,PuertoRican,Cuban,CentralorSouthAmerican,orotherSpanishcultureororigin,regardlessofrace.
White(notHispanic) / ApersonhavingoriginsinanyoftheoriginalpeoplesofEurope,theMiddleEast,orNorthAfrica.
Total / Theunduplicatedtotalacrosstherace/ethnicitydesignations.

Notethatchildrencanonlybereportedinonerace/ethnicitycategory.

U.S.DEPARTMENTOFEDUCATIONPAGE1OF8

OFFICEOFSPECIALEDUCATIONTABLE4

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA

DISABILITY/AGE
MENTALRETARDATION / HEARINGIMPAIRMENTS
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H) TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE2OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA(CONTINUED)

DISABILITY/AGE
SPEECHORLANGUAGEIMPAIRMENTS / VISUALIMPAIRMENTS
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H) TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE3OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA(CONTINUED)

DISABILITY/AGE
EMOTIONALDISTURBANCE / ORTHOPEDICIMPAIRMENTS
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE4OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA(CONTINUED)

DISABILITY/AGE
OTHERHEALTHIMPAIRMENTS / SPECIFICLEARNINGDISABILITIES
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE5OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA(CONTINUED)

DISABILITY/AGE
DEAF-BLINDNESS / MULTIPLEDISABILITIES
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE6OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONA(CONTINUED)

DISABILITY/AGE
AUTISM / TRAUMATICBRAININJURY
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional) / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE7OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONB

DISABILITY/AGE
ALLDISABILITIES
BASISOFEXIT: / 14 / 15 / 16 / 17 / 18 / 19 / 20 / 21 / 14-21
TOTAL / 22+
(Optional)
(A)TRANSFERED TO REGULAR EDUCATION
(B)GRADUATEDWITHREGULARHIGHSCHOOL
DIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

U.S.DEPARTMENTOFEDUCATIONPAGE8OF8

OFFICEOFSPECIALEDUCATIONTABLE4(continued)

ANDREHABILITATIVESERVICESOMBNO.: 1820-0521

OFFICEOFSPECIALEDUCATIONREPORTOFCHILDRENWITHDISABILITIESEXITING

PROGRAMSSPECIALEDUCATIONFROM JULY 1, 2005 THROUGH JUNE 30, 2006FORMEXPIRES: 08/31/2007

REPORTINGYEAR:______

STATE:______

SECTIONC

NUMBEROFSTUDENTSAGES14-21EXITINGSPECIALEDUCATIONBYRACE/ETHNICITY
RACE/ETHNICITY:
BASISOFEXIT: / AMERICANINDIANORALASKANATIVE / ASIANORPACIFICISLANDER / BLACK
(NotHispanic) / HISPANIC / WHITE
(NotHispanic) / TOTAL
(A)TRANSFERED TO REGULAR
EDUCATION
(B)GRADUATEDWITHREGULARHIGH
SCHOOLDIPLOMA
(C)RECEIVEDACERTIFICATE
(D)REACHEDMAXIMUMAGE
(E)DIED
(F)MOVED,KNOWNTOBE
CONTINUING
(G)DROPPEDOUT
(H)TOTAL(OFROWSA-G):

EDFORM: 869-3

ORIGINAL SUBMISSION/REVISION

CURRENT DATE: ______

[1]In States where students may receive a GED without dropping out of school, these students may be reported as graduating with a diploma (Row B). These are students who were jointly enrolled in secondary education and a GED program. In all other cases, GED recipients should be reported in Row G.