I, ________________________, having reached the age of 18 years, having never been determined to be incompetent for any purpose by a court of competent jurisdiction, and having received, at the age of majority, all educational decision making authority pursuant to California Education Code section 56041.5, hereby authorize my parent, _______________________, to make any and all decisions

for me regarding my entitlement to a Free Appropriate Public Special Education.

Such authority shall include, but is not limited to:

(1) Filing complaints with any public agency, such as the California Department of Education and U.S. Department of Education, Office for Civil Rights;

(2) Initiating and pursuing special education due process proceedings pursuant to California Education Code Sec. 56500, et seq. and any judicial appeals thereof;

(3) Attending IEP meetings and Due Process Mediations and pre-Due Process Mediations and signing IEP documents and mediation agreements with the same legal effect and authority as I would have absent this assignment;

(4) Authorizing or refusing to authorize assessments, services, or placements;

(5) Obtaining copies of any of my educational, psychological, medical, behavioral, or juvenile justice records, or any other materials and information related in any way to my special education, related services, supplementary aids and services, or transition services;

(6) Receiving information orally from any individual or agency (public or private) regarding my special education rights or services;

 (7) Exercising any other right or action on my behalf concerning my education with the same authority as I would have absent this assignment.

A photocopy or facsimile of this document shall have the same effect as the original.

Dated: _________________________________

Signed:_________________________________