MTPS Parent Referral for 504
MARLBORO TOWNSHIP PUBLIC SCHOOLS
HOW TO MAKE A PARENT REFERRAL FOR A 504 PLAN
Section 504 defines a qualified individual with a disability as anyone who:
- Has a mental or physical impairment which substantially limits one or more major life activities (e.g., caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working);
- Has a record of such an impairment; or
- Is regarded as having such impairment.
If you believe your child may qualify for a 504 plan based on the information to be provided (as indicated above), you can request an Initial Eligibility Determination Meeting for your child by submitting a letter to the Marlboro Special Services Department. This request can be sent to your child’s school, to the attention of the School Counselor.
Your request must have a statement similar to, “I am requesting a 504 plan for my child.” It is preferred, but not required, that you include information about your child and why you are requesting the evaluation. The request must include the following information:
- Parent name;
- Parent phone number;
- Parent address;
- Child’s full name;
- Child’s date of birth; and
- Child’s grade and school.
In addition to a parent letter of request, the parent must also provide supporting documentation from the outside professional/evaluator, stating their child’s diagnosis. This documentation should include as much of the following information as possible, including but not limited to the following:
- Specify the diagnosis of disability
- Describe how the disability affects a major life activity such as hearing, walking, seeing, speaking, breathing, learning or working
- Date of evaluation and/or visit
- Educational, developmental and relevant medical history
- List of administered tests with all scores, including subtest scores
- Description of the functional limitations resulting from the disability
- Recommendation for specific accommodations requested
- Explanation of how test results support the need for requested accommodations
- Examiners professional credentials cited and appropriate for the diagnosed disability
In order for your request to be processed, your letter must have an original signature. You can submit this letter two ways:
- Mail directly to your child’s school
- Sign, Scan, Attach and email to your child’s School Counselor/ 504 Building Liaison (contacts listed below)
**Please note that emails without an original signature will not be accepted.**
What happens next?
Your child’s School Counselor/504 Building Liaison (or other appropriate building representative) will contact you regarding next steps.