I am requesting Pre-Employment Transition Services based upon the criteria that I am a student with a disability. I understand I will need to meet with an ADEC Transition Consultant and develop a service plan that will be approved by Indiana Vocational Rehabilitation before I start receiving services.

For the specific purpose of participation in Pre-Employment Transition Services, I give permission for:

• Myself/my child to participate in all Pre-Employment Transition Services (pre-ETS) activities. I acknowledge that these activities are offered either one-on-one, in small groups, on school campus, and in the community.
• ADEC to provide transportation to and from pre-ETS events and activity locations related to the program needs of the student as appropriate.
• ADEC to provide basic first aid, including obtaining emergency response in case of accident, injury, or illness and accept responsibility for the costs of all such medical treatment.
• ADEC to release and exchange information with the schools, authorized personnel, and Indiana Vocational Rehabilitation including information in the student’s file that will enable the development of an action plan (e.g., IEP/504 plan, academic records, and psychological or behavioral reports or assessments).
• Myself/my child to continue to receive pre-ETS services during non-school days such as spring/winter/summer break our outside of school hours such as evenings and weeks as appropriate and as I choose.

I understand my I/my child is to comply with the program guidelines and recognize that I may voluntarily withdraw myself/my child from pre-ETS program services at any time.