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Section 504 Referral Form

ANNUNCIATION CATHOLIC SCHOOL
PARENTAL RIGHTS FOR SECTION 504

Parents have a right to:
- Have your child take part in and receive benefits from the educational program without
discrimination because of his/her disability. 
- Have your child be given an equal opportunity to participate in school programs and
extracurricular activities sponsored by the school district. 
- Receive notice with respect to identification, evaluation, or placement of your child and
be included in the decisions or actions relative to the 504 process. 
- Have the Section 504 Plan reviewed at least annually.
- Receive all information in your native language or another primary mode of
communication. 
- Examine your child’s educational records and obtain copies at a reasonable cost. 
- Request amendment of your child’s educational records if there is reason to believe that
they are inaccurate, misleading, or otherwise in violation of the privacy rights of your
child.
- File a local grievance with the Section 504 Coordinator
 

Appeal Process
A parent may file a written grievance with the Section 504 Coordinator to resolve any complaint
regarding the evaluation, identification, or implementation of Section 504 services.