Horry County Schools 335 Four Mile Road

Notice of Meeting Conway, SC 29526

(843) 488-6700

Park Hamilton Phillips 05/07/2004 55894 4559290849

Legal Name of Student DOB Local ID SUNS

1612 Highgrove Court

Myrtle Beach, SC 29575

Date Sent: 1/10/2017

Dear Beth Phillips and Stephen Phillips,

In order to discuss the educational needs of Park, you are invited to attend a conference scheduled for:

Date: 01/19/2017
Time: 2:00 PM
Location: Forestbrook Middle

The purpose of this meeting:

Manifestation Determination

Participants with the following positions will be attending the meeting:

Assistant Principal
Behavioral Health Counselor/Interventionist
General Education Teacher
Parent/Guardian
Parent/Guardian
LEA Representative
School Psychologist
Special Education Teacher/Provider
Student

We look forward to your attendance and participation in this meeting. You may invite other people that you believe will be
helpful to you. If the scheduled time and place is not convenient, please contact me immediately so that we can arrange a
mutually agreeable time and location for the meeting.

Name: Jacqueline Rucci, Teacher

Phone: (843) 236-7300

Email: JRucci@horrycountyschools.net

Forestbrook Middle
4430 Gator Lane, Myrtle Beach SC 29588
236-7300

Notice of Meeting Horry County Schools Page 1 of 4

 Horry County Schools 335 Four Mile Road
Notice of Meeting Conway, SC 29526
(843) 488-6700

Park Hamilton Phillips 05/07/2004 55894 4559290849

Legal Name of Student DOB Local ID SUNS

Please return this page to: Jacqueline Rucci

The meeting is currently scheduled for: 01/19/2017, beginning at 2:00 PM at Forestbrook Middle.

Parent Response
Please check one of the following:

_____ I will attend the meeting as scheduled

_____ I cannot attend the meeting as scheduled, but would like to reschedule for

_____________________________________ (Date, Time, and Location)

_____ I am unable to attend the meeting, and I do not wish to reschedule

_____ I would like to have the meeting conducted by telephone conference on:

_____________________________________ (Date and Time)

I require the following accommodation(s) at the meeting:

Interpreting services: _____ yes _____ no Language: ____________________________

Other special needs: ____________________________

_________________________________________ ________________ ____________________

Signature of parent/legal guardian/surrogate parent Date Telephone Number

Student Response (when applicable):

My signature below indicates that I am aware of the date and time of the meeting.

_________________________________________ _______________
Signature of Student Date

Notice of Meeting Horry County Schools Page 2 of 4

 Horry County Schools 335 Four Mile Road
Notice of Meeting Conway, SC 29526
(843) 488-6700

Park Hamilton Phillips 05/07/2004 55894 4559290849

Legal Name of Student DOB Local ID SUNS

Date Sent: 1/10/2017

Dear Park Phillips:

You are invited to attend a meeting which is scheduled for:

Date: 01/19/2017
Time: 2:00 PM
Location: Forestbrook Middle

The purpose of this meeting:

Manifestation Determination

Participants with the following positions will be attending the meeting:

Assistant Principal
Behavioral Health Counselor/Interventionist
General Education Teacher
Parent/Guardian
Parent/Guardian
LEA Representative
School Psychologist
Special Education Teacher/Provider
Student

We look forward to your attendance and participation in this meeting. You may invite other people that you believe will be
helpful to you. If the scheduled time and place is not convenient, please contact me immediately so that we can arrange a
mutually agreeable time and location for the meeting.

Notice of Meeting Horry County Schools Page 3 of 4

 Horry County Schools 335 Four Mile Road
Notice of Meeting Conway, SC 29526
(843) 488-6700

Park Hamilton Phillips 05/07/2004 55894 4559290849

Legal Name of Student DOB Local ID SUNS

Please return this page to: Jacqueline Rucci

The meeting is currently scheduled for: 01/19/2017, beginning at 2:00 PM at Forestbrook Middle.

Student Response (when applicable):

My signature below indicates that I am aware of the date and time of the meeting.

_________________________________________ _______________
Signature of Student Date

Notice of Meeting Horry County Schools Page 4 of 4