ATTACHMENT IV
(Click here for Word Format)
|
*STATEMENT OF ASSURANCE* |
Preschool Special Education Program
| Name: | ______________________________________________________________________ |
| Address: | ______________________________________________________________________ |
| ______________________________________________________________________ | |
| ______________________________________________________________________ | |
| Telephone Number: ____________________________________ | |
I understand that the __________________________________ program will provide support and technical assistance to other school and/or district staff who will express an interest in applying for the same waiver. The preschool special education program will appropriately allocate resources to support the planned activities. The preschool special education program will ensure the periodic assessment of the impact of planned activities and report its progress on achieving improved student outcomes to the State Education Department and the local community as appropriate.
Program Director’s
Name:________________________________________________________
(Print or Type)
Program Director’s Signature:_____________________________________________________ (Date)