Name of Special Education Director (or Superintendent)
School District Name
School District Address

RE: Child's Name, Date of Birth

Dear :

My/our child, (name of child), is a resident of (name of school district). Currently, (name of child), attends (name of school, class, program, etc.). (Name of child) has (brief description of disability) and qualifies for special education services under the IDEA.

I/we are writing to inform you that we do not agree with the school district's proposal to place (name of child) in (name the proposed school/program/class).

I/we have the following concern(s): (describe the concern or list and number them if you have several concerns. Include any ideas you have to resolve your concerns).

I/we intend to enroll (name of child) in private school beginning (date you plan to enroll child). The private school is (name of school) located at (address of school).

I am available to discuss our plans with you or answer any questions you have.

Sincerely,

Your Name
Phone Number

cc: Student's Permanent School File