SEAC Membership Application

To be a voting member, you must either be a student age 14 or older, who receives special education services from MPS, or the parent/guardian of a student in public or private school, who currently receives special education services from MPS.

During in person meetings a $25 childcare stipend is provided, and transportation is also provide if needed. Contact T amala Washington-Green Please check out our Community Facebook page SEAC Minneapolis Public School.

Namerequired

First Name

Last Name

Phone Numberrequired

Email Addressrequired

Home Mailing Addressrequired

Please mark all that apply

What school does your child attend?required

What is your child’s primary disability?required

What is your child's race/ethnicity?required

Have you ever served on an Advisory or other committee?required

Yes

No

I can attend at least monthly 4 meetings, 6:30- 8:30pm. Meeting are currently on the first Thursday of the month.required

Yes

No

I want to be a part of SEAC because...required

Topics I would like to see on SEAC agenda or discussion are...required

I need an interpreter in order to participate.required

Yes

No

If you selected yes, please indicate what language you need an interpreter for. If you answered no, leave blank.required

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