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\ SEPF \ IntentToApply
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Program
Program Name
Program URL
Program Type
Education
Residential
Combination
Application Type
Initial Application – New Operating Agency
Initial Application – Existing Approved Operating Agency
Address Line 1
Address Line 2
City
State
Alabama
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Zip
Disability Type(s)
Intellectual Disability (A)
Orthopedic Impairment (C)
Specific Learning Disability (D)
Visual Impairment (E)
Hearing Impairment (F)
Deafness (G)
Deaf-Blindness (H)
Speech and/or Language Impairment (I)
Emotional Disability (K)
Other Health Impairment (L)
Multiple Disabilities (M)
Developmental Delay (N)
Autism (O)
Traumatic Brain Injury (P)
Low Age
High Age
Details
Requestor
Requestor Name
Requestor Title
Requestor Email
Requestor Phone
Administrator
Administrator Name
Administrator Title
Administrator Email
Administrator Phone
An Illinois State Board of Education Principal Consultant in the Special Education Department will contact your application requestor regarding next steps in the application process upon receipt.
I, the undersigned, attest that I have read the Rules and Regulations for Approval of Nonpublic Special Education Programs under Section 14-7.02 of the School Code of Illinois found at:
https://www.isbe.net/Documents/401ARK.pdf
Signature
Signature Date
Intent To Apply Submitted
Your application has been submitted successfully. Please save confirmation number before you close this window for your future reference.
Confirmation#
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