TABLE 4

REPORT OF CHILDREN WITH DISABILITIES EXITING

SPECIAL EDUCATION

JULY 1, 2007 -- JUNE 30, 2008

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless it displays a
valid OMB control number. The valid OMB control number for this
information collection is 1820-0521. The time required to complete this
information collection is estimated to average 11 hours per SEA and 6
hours per LEA response, including the time to review instructions,
search existing data resources, gather the data needed, and complete and
review the information collection. If you have any comments concerning
the accuracy of the time estimate(s) or suggestions for improving this
form, please write to: U.S. Department of Education, Washington, D.C.
20202. If you have comments or concerns regarding the status of your
individual submission of this form, write directly to: Office of Special
Education Programs, U.S. Department of Education, 400 Maryland Avenue,
SW, Washington, D.C. 20202.

Authorization: P.L. 108-446, Section 618(a)(1)(A)(iv) and Section
618(a)(3); 34 CFR §§300.640, 300.641(b) through 300.641(d), 300.642(b),
300.644, 300.645

Due Date: November 1, 2008

Sampling Allowed: Yes

Send Form to: Patricia J. Guard, Acting Director

> Office of Special Education Programs
>
> Part B Data Reports
>
> Program Support Services Group
>
> Mail stop 2600
>
> 550 12th Street, S.W.
>
> Washington, D.C. 20202
>
> Attn: Cheryl Broady

General Instructions

Provide a count of the number of children with disabilities reported
under IDEA, Part B who exited special education between July 1, 2007 and
June 30, 2008. Data are to be provided by age, disability category,
basis of exit, race/ethnicity, gender, and limited English proficiency
(LEP) status. Include only children who were in special education at the
start of the reporting period, but were not in special education at the
end of the reporting period. All data provided must sum, as an
unduplicated count, to Section B of the table where you report the total
for all disabilities**.** The age of the student should reflect his/her
age in years on the date of the most recent child count prior to the
child's exiting, not at time of exit.

**In providing data for this collection, the State is to submit complete
and unsuppressed data.**

STATES SHOULD NOT PROVIDE PERCENTAGES IN SECTIONS A THROUGH E, AS THEY
WILL BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

[Sampling Guidelines]{.underline}

States may use sampling to obtain these data. When sampling is used, a
description of the sampling methodology, including a statement about how
the design will yield valid and reliable estimates that must be
submitted to OSEP for approval. The level of precision of the estimates
to be obtained must be specified. States must submit sampling plans to
OSEP for approval by September 1 of the reporting school year (that is,
the September prior to the start of the data collection period).

OSEP will evaluate the validity of the sampling plans using the
guidelines below.

1\. The sampling framework may include all school districts or a sample
of districts. If a State chooses to sample districts, all districts with
average daily memberships (ADM) of over 50,000 *must* be included in the
sample. States with fewer than 25 districts with ADMs over 25,000 *must*
include all districts with over 25,000 ADMs. The total number of
districts sampled *must* equal or exceed 100. If the total number of
districts in the State is 100 or fewer, data must be collected from all
districts.

2\. When sampling students, whether for all districts or for a sample of
districts, data must be collected separately for each Federal disability
category. All students whose domicile is in a district must be eligible
for the sample including those students served in cooperatives and/or
intermediate units or in residential programs out of the district.

3\. A minimum sample of 100 children in each disability category *must*
be used by all districts, except where the total number in a disability
category is less than 100. In such a case, data *must* be collected for
all students in that category.

States that use sampling will provide OSEP with weighted rather than
unweighted data. A description of the final sample sizes and the weights
used should also be provided at the time the data are provided.

Specific Instructions

[Sections A-E]{.underline}

In these tables, enter an unduplicated count of all children with
disabilities, by age, disability category, race/ethnicity, gender, and
limited English proficiency (LEP) status, who were in special education
at the start of the reporting period, but were not in special education
at the end of the reporting period. States must use a 12-month interval
for reporting exiting data**,** from July 1, 2007 to June 30, 2008.
Place zeros (0) in categories where no children have exited the program.
Enter (-9) for categories not used by the State.

Row A. Transferred to regular education. Total who were served in
special education at the start of the reporting period, but at some
point during that 12-month period, returned to regular education. These
are students who no longer have an IEP and are receiving all of their
educational services from a regular education program.

Row B. Graduated with regular high school diploma. Total who exited an
educational program through receipt of a high school diploma identical
to that for which students without disabilities are eligible. These are
students who met the same standards for graduation as those for students
without disabilities. As defined in 34 CFR §300.102(a)(3)(iv), "the term
*regular high school diploma* does not include an alternative degree
that is not fully aligned with the State's academic standards, such as a
certificate or a general educational development credential (GED)."

Row C. Received a certificate. Total who exited an educational program
and received a certificate of completion, modified diploma, or some
similar document. This includes students who received a high school
diploma, but did not meet the same standards for graduation as those for
students without disabilities. This category also includes students
receiving any alternative degree that is not fully aligned with the
State's academic standards, such as a certificate or a general
educational development credential (GED), so long as the student
remained continuously enrolled in the secondary educational program. If
your State does not use certificates, enter -9 in the appropriate cells.

Row D. Reached maximum age. Total who exited special education because
of reaching the maximum age for receipt of special education services,
including students with disabilities who reached the maximum age and did
not receive a diploma.

Row E. Died. Total who died.

Row F. Moved, known to be continuing. Total who moved out of the
catchment area or otherwise transferred to another district and are
*KNOWN* to be continuing in an educational program. There need not be
evidence that the student is continuing in special education, only that
he/she is continuing in an education program**.** This row includes
students in residential drug/alcohol rehabilitation centers,
correctional facilities, or charter schools if those facilities operate
as separate districts, excluding normal matriculation.

Row G. Dropped out. Total who were enrolled at the start of the
reporting period, were not enrolled at the end of the reporting period,
and did not exit special education through any of the other bases
described. This row includes dropouts, runaways, GED recipients (in
cases where students are required to drop out of the secondary
educational program in order to pursue the GED certificiate),[^1]
expulsions, status unknown, students who moved and are not known to be
continuing in another educational program, and other exiters from
special education.

Row H. Total of rows (A) through (G).

[Section A. Disability and Discrete Age by Basis of Exit]{.underline}

Report the number of students ages 14-21 who exited special education by
age-year, disability category, and basis of exit.

[Section B. Discrete Age by Basis of Exit]{.underline}

Report the total number of students ages 14-21 who exited special
education by age-year and basis of exit. These figures must equal the
sum of the data reported in Section A.

[Section C. Race/ethnicity by Basis of Exit]{.underline}

Report the total number of students ages 14-21 who exited special
education by race/ethnicity and basis of exit. These figures must equal
the total data for ages 14-21 reported in Section B.

In October 1997, OMB issued standards for the collection and
aggregration of data on race and ethinicity (see "Revisions to the
Standards for the Classification of Federal Data on Race and
Ethnicity").  In that announcement, OMB identified a minimum of five
racial categories \-- American Indian or Alaska Native, Asian, Black or
African American, Native Hawaiian or Other Pacific Islander, and White
\-- and one ethnic category \-- Hispanic or Latino.  Additionally, OMB
announced that individuals should be allowed to select as many
race/ethnicity categories as were applicable.  This data collection
allows for the reporting of only one race or ethnicity category per
individual and is therefore not in compliance with these standards.
OSEPand the Department of Education (ED) are considering changes to the
categories used for reporting aggregate data to bring this collection
into compliance with OMB's standards. For the time being, data should be
reported using the five racial categories described below. 

Race/ethnicity categories are defined as follows:

  --------------------- -------------------------------------------------
  American Indian or    A person having origins in any of the original
  Alaska Native         peoples of North and South America (including
                        Central America) and who maintains tribal
                        affiliation or community attachment.

  Asian or Other        A person having origins in any of the original
  Pacific Islander      peoples of the Far East, Southeast Asia, the
                        Indian subcontinent, or the Pacific Islands. This
                        includes, for example, Cambodia, China, India,
                        Japan, Korea, Malaysia, Pakistan, the Philippine
                        Islands, Thailand, Vietnam, Hawaii, Guam, and
                        Samoa.

  Black (not Hispanic)  A person having origins in any of the Black
                        racial groups of Africa.

  Hispanic              A person of Mexican, Puerto Rican, Cuban, Central
                        or South American, or other Spanish culture or
                        origin, regardless of race.

  White (not Hispanic)  A person having origins in any of the original
                        peoples of Europe, the Middle East, or North
                        Africa.

  Total                 The unduplicated total across the race/ethnicity
                        designations.
  --------------------- -------------------------------------------------

Note that children can only be reported in [one]{.underline}
race/ethnicity category.

[Section D. Gender by Basis of Exit]{.underline}

Report the total number of students ages 14-21 who exited special
education by gender and basis of exit. These figures must equal the
total data reported in Section B.

[Section E. Limited English Proficiency Status by Basis of
Exit]{.underline}

Report the total number of students ages 14-21 who exited special
education by LEP status. These figures must equal the total data
reported in Section B.

Limited English Proficient. A child who meets the definition of a
limited English proficient child under the Elementary and Secondary
Education Act, 20 U.S.C. Section 7801(A)(25):

"The term 'limited English proficient,' when used with respect to an
individual, means an individual -

\(A\) who is aged 3 through 21;

\(B\) who is enrolled or preparing to enroll in an elementary school or
secondary school;

\(C\)

\(i\) who was not born in the United States or whose native language is
a language other than English;

> \(ii\)
>
> \(I\) who is a Native American or Alaska Native, or a native resident
> of the outlying areas; and
>
> \(II\) who comes from an environment where a language other than
> English has had a significant impact on the individual\'s level of
> English language proficiency; or
>
> \(iii\) who is migratory, whose native language is a language other
> than English, and who comes from an environment where a language other
> than English is dominant; and

\(D\) whose difficulties in speaking, reading, writing, or understanding
the English language may be sufficient to deny the individual -

> \(i\) the ability to meet the State\'s proficient level of achievement
> on State assessments described in section 6311(b)(3) of this title;

\(ii\) the ability to successfully achieve in classrooms

where the language of instruction is English; or

\(iii\) the opportunity to participate fully in society."

LEP status should reflect the child's status as of the date of exit.

U.S. DEPARTMENT OF EDUCATION PAGE 1 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION **FROM** JULY 1, 2007 THROUGH JUNE 30, 2008
FORM EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A. DISCRETE AGE AND DISABILITY BY BASIS OF EXIT

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">MENTAL RETARDATION</td>
<td colspan="10">HEARING IMPAIRMENTS</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 2 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A (CONTINUED)

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">SPEECH OR LANGUAGE IMPAIRMENTS</td>
<td colspan="10">VISUAL IMPAIRMENTS</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 3 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A (CONTINUED)

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">EMOTIONAL DISTURBANCE</td>
<td colspan="10">ORTHOPEDIC IMPAIRMENTS</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 4 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A (CONTINUED)

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">OTHER HEALTH IMPAIRMENTS</td>
<td colspan="10">SPECIFIC LEARNING DISABILITIES</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 5 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A (CONTINUED)

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">DEAF-BLINDNESS</td>
<td colspan="10">MULTIPLE DISABILITIES</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 6 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION A (CONTINUED)

<table>
<colgroup>
<col style="width: 19%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">AUTISM</td>
<td colspan="10">TRAUMATIC BRAIN INJURY</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td>14-21 TOTAL</td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td><p>(A) TRANSFERED TO REGULAR</p>
<p>EDUCATION</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH</p>
<p>SCHOOL DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 7 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION B. DISCRETE AGE BY BASIS OF EXIT

<table>
<colgroup>
<col style="width: 25%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="10">ALL DISABILITIES</td>
</tr>
<tr class="even">
<td>14</td>
<td>15</td>
<td>16</td>
<td>17</td>
<td>18</td>
<td>19</td>
<td>20</td>
<td>21</td>
<td><p>14-21</p>
<p>TOTAL</p></td>
<td><p>22+</p>
<p>(Optional)</p></td>
</tr>
<tr class="odd">
<td>(A) TRANSFERRED TO REGULAR EDUCATION</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH SCHOOL</p>
<p>DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>© RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 8 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION B (CONTINUED)

<table>
<colgroup>
<col style="width: 27%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2">BASIS OF EXIT:</td>
<td colspan="9"><p>ALL DISABILITIES</p>
<p>(PERCENT)<sup>1</sup></p></td>
</tr>
<tr class="even">
<td><p>14</p>
<p>(PERCENT)</p></td>
<td><p>15</p>
<p>(PERCENT)</p></td>
<td><p>16</p>
<p>(PERCENT)</p></td>
<td><p>17</p>
<p>(PERCENT)</p></td>
<td><p>18</p>
<p>(PERCENT)</p></td>
<td><p>19</p>
<p>(PERCENT)</p></td>
<td><p>20</p>
<p>(PERCENT)</p></td>
<td><p>21</p>
<p>(PERCENT)</p></td>
<td><p>14-21</p>
<p>TOTAL</p>
<p>(PERCENT)</p></td>
</tr>
<tr class="odd">
<td>(A) TRANSFERED TO REGULAR EDUCATION</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="even">
<td><p>(B) GRADUATED WITH REGULAR HIGH SCHOOL</p>
<p>DIPLOMA</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="odd">
<td>(C) RECEIVED A CERTIFICATE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="even">
<td>(D) REACHED MAXIMUM AGE</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="odd">
<td>(E) DIED</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="even">
<td><p>(F) MOVED, KNOWN TO BE</p>
<p>CONTINUING</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="odd">
<td>(G) DROPPED OUT</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
<tr class="even">
<td>(H) TOTAL (OF ROWS A-G):</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td>100%</td>
</tr>
</tbody>
</table>

^1^ STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL
BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 9 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION C. RACE/ETHNICITY BY BASIS OF EXIT

+----------------+--------+--------+--------+--------+--------+--------+
| BASIS OF EXIT  | RA     |        |        |        |        |        |
|                | CE/ETH |        |        |        |        |        |
|                | NICITY |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
|                | AM     | ASIAN  | BLACK  | HI     | WHITE  | TOTAL  |
|                | ERICAN | OR     |        | SPANIC |        |        |
|                | INDIAN | OTHER  | (Not   |        | (Not   |        |
|                | OR     | P      | His    |        | His    |        |
|                | ALASKA | ACIFIC | panic) |        | panic) |        |
|                | NATIVE | IS     |        |        |        |        |
|                |        | LANDER |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(A\)          |        |        |        |        |        |        |
| TRANSFERED TO  |        |        |        |        |        |        |
| REGULAR        |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| EDUCATION      |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(B\)          |        |        |        |        |        |        |
| GRADUATED WITH |        |        |        |        |        |        |
| REGULAR HIGH   |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| SCHOOL DIPLOMA |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(C\) RECEIVED |        |        |        |        |        |        |
| A CERTIFICATE  |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(D\) REACHED  |        |        |        |        |        |        |
| MAXIMUM AGE    |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(E\) DIED     |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(F\) MOVED,   |        |        |        |        |        |        |
| KNOWN TO BE    |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| CONTINUING     |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(G\) DROPPED  |        |        |        |        |        |        |
| OUT            |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(H\) TOTAL    |        |        |        |        |        |        |
| (OF ROWS A-G): |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 10 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION C (CONTINUED)

+----------------+--------+--------+--------+--------+--------+--------+
| BASIS OF EXIT  | RA     |        |        |        |        |        |
|                | CE/ETH |        |        |        |        |        |
|                | NICITY |        |        |        |        |        |
|                |        |        |        |        |        |        |
|                | (PERCE |        |        |        |        |        |
|                | NT)^1^ |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
|                | AM     | ASIAN  | BLACK  | HI     | WHITE  | TOTAL  |
|                | ERICAN | OR     |        | SPANIC |        |        |
|                | INDIAN | OTHER  | (Not   |        | (Not   | (PE    |
|                | OR     | P      | His    | (PE    | His    | RCENT) |
|                | ALASKA | ACIFIC | panic) | RCENT) | panic) |        |
|                | NATIVE | IS     |        |        |        |        |
|                |        | LANDER | (PE    |        | (PE    |        |
|                | (PE    |        | RCENT) |        | RCENT) |        |
|                | RCENT) | (PE    |        |        |        |        |
|                |        | RCENT) |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(A\)          |        |        |        |        |        | 100%   |
| TRANSFERED TO  |        |        |        |        |        |        |
| REGULAR        |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| EDUCATION      |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(B\)          |        |        |        |        |        | 100%   |
| GRADUATED WITH |        |        |        |        |        |        |
| REGULAR HIGH   |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| SCHOOL DIPLOMA |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(C\) RECEIVED |        |        |        |        |        | 100%   |
| A CERTIFICATE  |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(D\) REACHED  |        |        |        |        |        | 100%   |
| MAXIMUM AGE    |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(E\) DIED     |        |        |        |        |        | 100%   |
+----------------+--------+--------+--------+--------+--------+--------+
| \(F\) MOVED,   |        |        |        |        |        | 100%   |
| KNOWN TO BE    |        |        |        |        |        |        |
|                |        |        |        |        |        |        |
| CONTINUING     |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(G\) DROPPED  |        |        |        |        |        | 100%   |
| OUT            |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+
| \(H\) TOTAL    |        |        |        |        |        | 100%   |
| (OF ROWS A-G): |        |        |        |        |        |        |
+----------------+--------+--------+--------+--------+--------+--------+

^1^ STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL
BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 11 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION D. GENDER BY BASIS OF EXIT

  ------------------------- --------------- --------------- ---------------
  BASIS OF EXIT:            GENDER                          

                            MALE            FEMALE          TOTAL

  \(A\) TRANSFERED TO                                       
  REGULAR EDUCATION                                         

  \(B\) GRADUATED WITH                                      
  REGULAR HIGH SCHOOL                                       
  DIPLOMA                                                   

  \(C\) RECEIVED A                                          
  CERTIFICATE                                               

  \(D\) REACHED MAXIMUM AGE                                 

  \(E\) DIED                                                

  \(F\) MOVED, KNOWN TO BE                                  
  CONTINUING                                                

  \(G\) DROPPED OUT                                         

  \(H\) TOTAL (OF ROWS                                      
  A-G):                                                     
  ------------------------- --------------- --------------- ---------------

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 12 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION D (CONTINUED)

+-------------------------+--------------+--------------+--------------+
| BASIS OF EXIT:          | GENDER       |              |              |
|                         |              |              |              |
|                         | (PERCENT)^1^ |              |              |
+-------------------------+--------------+--------------+--------------+
|                         | MALE         | FEMALE       | TOTAL        |
|                         |              |              |              |
|                         | (PERCENT)    | (PERCENT)    | (PERCENT)    |
+-------------------------+--------------+--------------+--------------+
| \(A\) TRANSFERED TO     |              |              |              |
| REGULAR EDUCATION       |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(B\) GRADUATED WITH    |              |              |              |
| REGULAR HIGH SCHOOL     |              |              |              |
| DIPLOMA                 |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(C\) RECEIVED A        |              |              |              |
| CERTIFICATE             |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(D\) REACHED MAXIMUM   |              |              |              |
| AGE                     |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(E\) DIED              |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(F\) MOVED, KNOWN TO   |              |              |              |
| BE CONTINUING           |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(G\) DROPPED OUT       |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(H\) TOTAL (OF ROWS    | 100%         | 100%         | 100%         |
| A-G):                   |              |              |              |
+-------------------------+--------------+--------------+--------------+

^1^ STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL
BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 13 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION E. LIMITED ENGLISH PROFICIENCY BY BASIS OF EXIT

  ------------------------- --------------- --------------- ---------------
  BASIS OF EXIT:            LIMITED ENGLISH                 
                            PROFICIENCY                     
                            STATUS                          

                            YES             NO              TOTAL

  \(A\) TRANSFERED TO                                       
  REGULAR EDUCATION                                         

  \(B\) GRADUATED WITH                                      
  REGULAR HIGH SCHOOL                                       
  DIPLOMA                                                   

  \(C\) RECEIVED A                                          
  CERTIFICATE                                               

  \(D\) REACHED MAXIMUM AGE                                 

  \(E\) DIED                                                

  \(F\) MOVED, KNOWN TO BE                                  
  CONTINUING                                                

  \(G\) DROPPED OUT                                         

  \(H\) TOTAL (OF ROWS                                      
  A-G):                                                     
  ------------------------- --------------- --------------- ---------------

ED FORM: 869-3

U.S. DEPARTMENT OF EDUCATION PAGE 14 OF 14

OFFICE OF SPECIAL EDUCATION TABLE 4 (continued)

AND REHABILITATIVE SERVICES OMB NO.: 1820-0521

OFFICE OF SPECIAL EDUCATION REPORT OF CHILDREN WITH DISABILITIES EXITING

PROGRAMS SPECIAL EDUCATION FROM JULY 1, 2007 THROUGH JUNE 30, 2008 FORM
EXPIRES: 08/31/2009

STATE: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SECTION E. LIMITED ENGLISH PROFICIENCY BY BASIS OF EXIT

+-------------------------+--------------+--------------+--------------+
| BASIS OF EXIT:          | LIMITED      |              |              |
|                         | ENGLISH      |              |              |
|                         | PROFICIENCY  |              |              |
|                         | STATUS       |              |              |
|                         |              |              |              |
|                         | (PERCENT)^1^ |              |              |
+-------------------------+--------------+--------------+--------------+
|                         | YES          | NO           | TOTAL        |
|                         |              |              |              |
|                         | (PERCENT)    | (PERCENT)    | (PERCENT)    |
+-------------------------+--------------+--------------+--------------+
| \(A\) TRANSFERED TO     |              |              |              |
| REGULAR EDUCATION       |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(B\) GRADUATED WITH    |              |              |              |
| REGULAR HIGH SCHOOL     |              |              |              |
| DIPLOMA                 |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(C\) RECEIVED A        |              |              |              |
| CERTIFICATE             |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(D\) REACHED MAXIMUM   |              |              |              |
| AGE                     |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(E\) DIED              |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(F\) MOVED, KNOWN TO   |              |              |              |
| BE CONTINUING           |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(G\) DROPPED OUT       |              |              |              |
+-------------------------+--------------+--------------+--------------+
| \(H\) TOTAL (OF ROWS    | 100%         | 100%         | 100%         |
| A-G):                   |              |              |              |
+-------------------------+--------------+--------------+--------------+

^1^ STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION, AS THEY WILL
BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

ED FORM: 869-3

[^1]: In States where students may receive a GED without dropping out of
    school, these students may be reported as receiving a certificate
    (Row C). These are students who were jointly enrolled in secondary
    education and a GED program. In all other cases, GED recipients
    should be reported in Row G.