Request for Due Process Hearing



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Bureau of Indian Education

Request for Due Process Hearing
THIS FORM IS NOT REQUIRED TO REQUEST A DUE PROCESS HEARING

AS LONG AS THE FORM OR DOCUMENT (i.e. LETTER) USED MEETS IDEA 2004 CONTENT REQUIREMENTS

The parent or the school may file a due process complaint on any matter relating to a proposal or a refusal to initiate or change the identification, evaluation, educational placement or the provision of a Free Appropriate Public Education (FAPE) to a child. The due process complaint must allege a violation that happened not more than two years before you or the school knew or should have known about the alleged action that forms the basis of the due process complaint. Unless, the parent was prevented from filing a due process complaint under one of the allowable exceptions listed in 34 CFR §300.511(f).
GENERAL INFORMATION
*Name of Student:       Gender: Female  Male  Date of Birth:      /     /     

Month / Day / Year

*Address of Student:       Age:       Grade:      

(If homeless, may use available contact information)

Name of Parent/Guardian:       Home/Cell Number: (     )      -     
Address of Parent/Guardian:       Work Number: (     )      -     
*Name of School Student attends:      




SUMMARY OF COMPLAINT

*Describe the nature of the complaint. Include facts relevant to the dispute (attach additional pages as necessary):

     



*Briefly explain the resolution you are seeking (attach additional pages as necessary):

     

Signature of Parent/Guardian or Person filing the request Date

Please contact the Bureau of Indian Education, Division of Performance and Accountability, Special Education at (505) 563-5264 for additional information. This Request for Due Process Hearing form or if using another document (i.e. letter) that document must be provided to the other party and mailed, faxed or hand-delivered to:


Bureau of Indian Education

Division of Performance and Accountability

Attention: Supervisory Education Specialist – Special Education

1011 Indian School Rd, Suite 332

Albuquerque, NM 87104

Fax: (505) 563-5233



*IDEA 2004 content requirements Revision September 2010


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