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Abbreviated School Day Program Sample Forms

The Oregon Department of Education (ODE) has created a package of sample forms designed to support districts in onboarding students into an Abbreviated School Day Program, ensure accurate data collection, and help families understand their rights and what it is that they are agreeing to if they consent to placement of their student on an Abbreviated School Day Program. To make this information accessible to all, the forms are available in multiple languages.

These forms are provided by the ODE as a reference tool to assist school districts in implementing the requirements of Abbreviated School Day Programs. Their use is not mandatory. School districts may choose to use these forms, develop their own, or adapt them to their specific needs to ensure compliance with all state and federal laws, including ORS statutes pertaining to Abbreviated School Day Programs (ORS 343.321 to ORS 343.333), the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and the Individuals with Disabilities Education Act (IDEA). ODE recommends that school districts seek legal counsel when establishing implementation and documentation procedures related to Abbreviated School Day Programs to ensure they are implemented in a manner that meets state and federal requirements consistent with local context.

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  1. إقرار ولي الأمر بحقوقه قبل مناقشة إمكانية إدراج الطالب في يوم دراسي مختصر
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. المراجعة المطلوبة للمعلومات لتحديد ما إذا كان من المناسب بدء برنامج يوم دراسي مختصر
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. الموافقة المستنيرة والخطية على بدء برنامج يوم دراسي مختصر
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. إقرار ولي الأمر بحقوقه قبل مراجعة إمكانية إدراج الطالب في يوم دراسي مختصر
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. مراجعة المعلومات والموافقة المطلوبة لاستمرار برنامج اليوم الدراسي المختصر
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. الموافقة المستنيرة والخطية على تمديد الجدول الزمني لاجتماعات برنامج اليوم الدراسي المختصر
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. مراجعة المدير: الإلحاق ببرنامج اليوم الدراسي المختصر
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. الموافقة الخطية على تمديد الجدول الزمني للعودة إلى يوم دراسي كامل بعد سحب ولي الأمر لموافقته
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. An Sam me In Apwarano ren ar Pung kena Me Mwan Kakapas Usun ew Fichin Programen Amwochenon Ranin Sukun
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Mochenin Chekin ren Poraus ren ar repwe Finata ika ew Apoputan Iseisenong won ew Programen Amwochenon Ranin Sukun a kan fichino
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Asineino me pwan Maaken Amumuta ren Apoputan Iseisenong won echo Programen Amwochenon Ranin Sukun
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. An Sam me In Apwarano ren ar Pung kena Me Mwan Chekin Iseisenong won ew Programen Amwochenon Ranin Sukun
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Kopwene Fofori Chekin ren Poraus me pwan Amumutan ren Sopwesopwenon ren ew Programen Amwochenon Ranin Sukun
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Asineino me pwan Maaken Amumuta ren Atamenon Fansoun Mwichen Programen Amwochenon Ranin Sukun
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Maaken Amutata ren Atamenon Attun Fansoun ren Niwin Sefan ngeni ew Unusen Ranin SukunMurin An Sam me In Asopwenon ren Amumuta
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. 家长在讨论（孩子）可能安排上“缩短学时课程”前对自身权利的确认
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. 对信息进行必要审查以判断初次安排上“缩短学时课程”是否合适
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. 关于初次安排上“缩短学时课程”的知情书面同意书
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. 家长在审核（孩子）被安排上“缩短学时课程”前对自身权利的确认
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. 关于继续实施“缩短学时课程”的信息审查及知情同意要求
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. 延长“缩短学时课程”会期的知情书面同意书
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. 学区总监缩短上学日项目安置审查示例表
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. 在家长撤销同意书后 延长恢复全日制课程时间 的书面同意书
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. 家長在討論（孩子）可能安排上“縮短學時課程”前對自身權利的確認
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. 對資訊進行必要審查以判斷初次安排上“縮短學時課程”是否合適
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. 關於初次安排上“縮短學時課程”的知情書面同意書
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. 家長在審核（孩子）被安排上“縮短學時課程”前對自身權利的確認
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. 關於繼續實施“縮短學時課程”的資訊審查及知情同意要求
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. 延長“縮短學時課程”會期的知情書面同意書
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. 學監審核：安排上“縮短學時課程
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. 在家長撤銷同意書後 延長恢復全日制課程時間 的書面同意書
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. Расписка в ознакомлении с правами родителей перед совещанием о возможном переводе учащегося на сокращенный учебный день
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Сведения, обязательные к рассмотрению при вынесении решения о допустимости перевода учащегося на сокращенный учебный день
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Информированное письменное согласие с переводом на сокращенный учебный день
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. Расписка в ознакомлении с правами родителей перед пересмотром решения о переводе учащегося на сокращенный учебный день
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Сведения, обязательные к рассмотрению, и согласие с дальнейшим обучением по программе сокращенного учебного дня
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Информированное письменное согласие на увеличение периодичности совещаний по вопросу сокращенного учебного дня
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Инспекторская проверка по факту зачисления учащегося в программу сокращенного учебного дня
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. Письменное согласие на продление сроков перевода учащегося на полный учебный день после отзыва родительского согласия
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. Qiritaanka Waalidka ee Xuquuqdooda Kahor Inta aan laga Wada Hadlin Barnaamij Maalin dugsiyeedka la soo Gaabiyey ee Suurtogalka ah
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Dibu-eegista Macluumaadka loo Baahan Yahay si loo Go'aamiyo Haddii Meelaynta hore ee Barnaamijka Maalin Dugsiyeedka la soo Gaabiyey ay ku Habboon Tahay
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Oggolaanshaha La Wargeliyay ee Qoran ee loogu talogalay Bilawga Ku-meelaynta Barnaamijka Maalin Dugsiyeedka la soo Gaabiyey
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. Qiraalka Waalidka ee Xuquuqdooda Kahor Inta aan Dib loo Eegin Meelaynta Barnaamijka Maalin Dugsiyeedka la soo Gaabiyey
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Dibu-eegista Loo Baahan Yahay ee Macluumaadka iyo Oggolaanshaha sii wadida Barnaamijka Maalin Dugsiyeedka la soo Gaabiyey
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Oggolaanshaha Qoraalka ah ee Kordhinta Wakhtiga Kulanka ee Barnaamijka Maalin Dugsiyeedk la soo Gaabiyey
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Dibu-eegista Kormeeraha:Meelaynta Barnaamij Maalmeedka Dugsiga ee La Soo Gaabiyay
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. Oggolaanshaha Qoraalka ah ee Kordhinta Jadwalka Ku soo Noqoshada Maalin Dugsiyeedka Buuxa ee Daba Socda Oggolaanshaha Ka Noqoshada Waalidka
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. Reconocimiento de los derechos de los padres antes de hablar sobre un posible Programa de Jornada Escolar Abreviada
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Revisión obligatoria de la información para determinar si es apropiada una colocación inicial en un Programa de Jornada Escolar Abreviada
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Consentimiento informado y escrito para la colocación inicial en un Programa de Jornada Escolar Abreviada
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. Reconocimiento de los derechos de los padres antes de revisar la colocación en un Programa de Jornada Escolar Abreviada
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Revisión obligatoria de la información y consentimiento para la continuación de un Programa de Jornada Escolar Abreviada
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Consentimiento informado y por escrito para extender el cronograma de reuniones del programa de jornada escolar abreviada
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Revisión del Superintendente:Colocación en un programa de jornada escolar abreviad
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. Consentimiento por escrito para extender el plazo de regreso a la jornada escolar completa tras la revocación del consentimiento de los padres
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. Ознайомлення батьків зі своїми правами перед обговоренням можливої участі в Програмі скороченого навчального дня
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Обов'язковий розгляд інформації для визначення доцільності зарахування учня до Програми скороченого навчального дня.
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Інформована письмова згода на первинне зарахування учня до Програми скороченого навчального дня
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. Підтвердження батьками того, що вони ознайомилися зі своїми правами перед переглядом рішення щодо участі учня в Програмі скороченого навчального дня
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Обов'язковий перегляд інформації та згода на продовження участі учня в Програмі скороченого навчального дня
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Інформована письмова згода на продовження зустрічей щодо Програми скороченого навчального дня
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Перегляд Керівником шкільного округу рішення щодо зарахування учня до Програми скороченого навчального дня
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. Письмова згода на продовження терміну повернення до повного навчального дня після відкликання батьками згоди
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


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  1. Phụ Huynh Xác Nhận Quyền của mình Trước Khi Thảo Luận về Chương Trình Ngày Học Rút Gọn Có Thể Có
    (Parent Acknowledgement of their Rights Prior to Discussion of a Possible Abbreviated School Day Program)
  2. Cần Xem Xét Thông Tin để Xác Định xem Việc Sắp Xếp Ban Đầu vào Chương Trình Ngày Học Rút Gọn có Phù Hợp hay không
    (Required Review of Information to Determine if an Initial Placement on an Abbreviated School Day Program is Appropriate)
  3. Sự Đồng Ý có Hiểu Biết bằng Văn Bảncho Việc Sắp Xếp Ban Đầu vào Chương Trình Ngày Học Rút Gọn
    (Informed and Written Consent for Initial Placement on an Abbreviated School Day Program)
  4. Phụ Huynh Xác Nhận Quyền của Mình Trước khi Xem Xét việc Sắp Xếp vào Chương Trình Ngày Học Rút Gọn
    (Parent Acknowledgement of their Rights Prior to Reviewing Placement on an Abbreviated School Day Program)
  5. Yêu Cầu Xem Xét Thông Tin và Đồng Ý để Tiếp Tục Chương Trình Ngày Học Rút Gọn
    (Required Review of Information and Consent for Continuation of an Abbreviated School Day Program)
  6. Sự Đồng Ý Bằng Văn Bản và Thông Báo về Việc Gia Hạn Thời Gian Họp của Chương Trình Ngày Học Rút Gọn
    (Informed and Written Consent for Extending Abbreviated School Day Program Meeting Timeline)
  7. Đánh Giá của Giám Đốc Học Khu: Sắp Xếp Vào Chương Trình Ngày Học Rút Ngắn
    (Superintendent Review Placement on an Abbreviated School Day Program Sample Form)
  8. Văn Bản Đồng Ý Gia Hạn Thời Hạn Trở Lại Trường Học Toàn Thời Gian Sau Khi Phụ Huynh Rút Lại Sự Đồng Ý
    (Written Consent for Extending Timeline for Return to a Full School Day Following Parent Revocation of Consent)​


Meeting Flowcharts

Contact:
ODE.ASDPquestions@ode.oregon.gov