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After completing last field, save document to hard drive to make future updates or click print button.   \nILLINOIS STATE BOARD OF EDUCATION  \nSpecial Education Services Division  \n100 North First Street, N-243  \nSpringfield, Illinois 62777-0001  \nPARENT REQUEST FOR AN IMPARTIAL DUE PROCESS HEARING OFFICER  \nINSTRUCTIONS: This form has been developed to assist parents in requesting an impartial due process hearing. The completed form must be given to the superintendent of the student’s resident district. Within 5 days of receipt of the request for a hearing, the local school district will forward a copy of the completed form to the Illinois State Board of Education to be shared with the appointed hearing officer. A local school district may not deny a request for a due process hearing. All parties involved in the dispute are advised to review the due process regulations found at 23 Illinois Administrative Code 226.605 and Section 14-8.02 of the School Code. The information reported on this form will be subject to the confidentiality requirements of the individuals with Disabilities Education Act and the Illinois School Student Records Act.  \n\n| NAME OF STUDENT ON WHOSE BEHALF THE HEARING IS REQUESTED | STUDENT’S BIRTHDATE (Month/Day/Year) |\n| --- | --- |\n\nPARENT’S/GUARDIANS’ LANGUAGE/MODE OF COMMUNICATION  \nA BILINGUAL OR SIGN LANGUAGE INTERPRETER IS REQUESTED  \n YES  NO IF YES, Specify language/mode of communication    \n\n| NAME OF PARENT/GUARDIAN | TELEPHONE (Include Area Code) |\n| --- | --- |\n| ADDRESS (Street, City, State, Zip Code) | FAX (Include Area Code) |\n|  | E-MAIL |\n| NAME OF ATTORNEY FOR THE PARENT/GUARDIAN (If this section is completed all information and correspondence regarding the due process will be forwarded directly to the attorney or representative.) | TELEPHONE (Include Area Code) |\n| ADDRESS (Street, City, State, Zip Code) | FAX (Include Area Code) |\n|  | E-MAIL |\n| DISTRICT NAME AND NUMBER | TELEPHONE (Include Area Code) |\n| ADDRESS (Street, City, State, Zip Code) | FAX (Include Area Code) |\n|  | E-MAIL |\n| NAME OF THE SCHOOL STUDENT ATTENDS | TELEPHONE (Include Area Code) |\n| ADDRESS (Street, City, State, Zip Code) | FAX (Include Area Code) |\n|  | E-MAIL |\n\nA DESCRIPTION OF THE DISPUTE (Attach additional pages if necessary.)  \nA DESCRIPTION OF THE RESOLUTION OR ACTION YOU ARE SEEKING (Attach additional pages if necessary.)  \n__________________________________________________ ______________________________________________________________________________  \nDate Submitted to District Signature of Parent/Guardian  \nISBE 19-86A (9/12)  Print   Reset Form","cbCaiocUJQTHZ41k","https://ap.wps.com/l/cbCaiocUJQTHZ41k","pdf",170005,"English","# Form Purpose and Submission Requirements\n# Required Parties and Contact Information\n## Student Details and Parent Communication Needs\n## Attorney and District/School Details\n# Statement of Dispute and Requested Resolution","[{\"question\":\"What regulations and confidentiality rules should parties review?\",\"answer\":\"Parties are advised to review the due process regulations in 23 Illinois Administrative Code 226.605 and Section 14-8.02 of the School Code, and the confidentiality requirements under IDEA and the Illinois School Student Records Act.\"}]","PARENT REQUEST FOR AN IMPARTIAL DUE PROCESS HEARING OFFICER - Instructions and Form ISBE 19-86A | PDF",1791600619]