Act 55 of 2022 Student Enrollment Notification Form for the 2022-23 School Year
On July 8, 2022, Governor Tom Wolf signed Act 55 of 2022 into law.
This Act permits the following for the 2022-23 school year:
- A student with a disability who was enrolled during the 2021-22 school year and turned age 21 (either during the 2021-22 school year or between the end of the 2021-22 and the beginning of the 2022-23school year) may attend a school entity during the 2022-23 school year and receive services as outlined in their most recent Individualized Education Program (IEP) with all the protections under the Individuals with Disabilities Education Act (IDEA).
To qualify for an additional year, a student had to be enrolled in one of the following school entities in Pennsylvania during the 2021-22 school year: a school district, intermediate unit, area career and technical school, charter school, cyber charter school, regional charter school, approved private school, or chartered school for the education of the deaf and blind.
Parents/guardians and students interested in the above option for the 2022-23 school year must submit this Act 55 of 2022 Student Enrollment Notification Form to the school entity that the student will attend in the 2022-23 school year on or before August 1, 2022. Do not submit the form to the Pennsylvania Department of Education (PDE).
- Complete the Act 55 of 2022 Enrollment Notification Form for the 2022-23 school year.
- Contact the school entity that the student will attend during the 2022-23 school year for an email address to submit the form.
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Submit the completed form to the child’s school entity on or before August 1, 2022.
- Both the parent/guardian and the student must complete this form if a student with a disability was enrolled during the 2021-22 school year, turned 21 during the time periods listed above, and intends to return to school for the 2022-23 school year.
Date:
Name of Student: (First, Middle, Last)
Student Date of Birth:
Student School ID Number (if known):
Student Address:
Name of Parent/Guardian:
Parent/Guardian Address:
Parent/Guardian Phone Number:
Name of School Entity (e.g., school district, intermediate unit, area career and technical school, charter school, regional charter school, cyber charter school, Approved Private School, and Chartered School for the Deaf and Blind) the student attended during the 2021-22 school year:
Name of School Building the student attended during the 2021-22 school year:
Grade Level in the 2021-22 school year:
Name of Student’s Homeroom or Primary Teacher in the 2021-22 school year:
I confirm the above-named student meets the following criteria and is eligible to enroll under Act 55 of 2022:
[ ] Is a student with a disability as defined in 22 Pa. Code § 14.101 (relating to definitions) who has reached 21 years of age during the 2021-22 school year or between the end of the 2021-22 school year and the beginning of the 2022-23 school year and was enrolled for the 2021-22 school year
Signature of Parent/Guardian:
Printed Parent/Guardian Name:
Signature of Student:
Printed Name of Student:
The Act 55 of 2022 Student Enrollment Notification Form must be submitted to the student’s school entity on or before August 1, 2022. Do not submit this form to the PDE.