THE SCHOOL DISTRICT OF PHILADELPHIA
Request for Interim Placement
While waiting for a disciplinary hearing and decision, schools may request an interim placement if the student’s presence poses a threat to the school community. For special education students, interim assignments will only be granted if there is documentation of weapons, drugs, or serious bodily injury, regardless of the behavior being a manifestation of the student’s disability.
Requests for an Interim Placement should be submitted via email to your school’s assigned support person in the Office of Student Rights and Responsibilities no later than the second day of the student’s suspension. (If you are not sure who your support person is, call 215-400-4830.)
NOTE: If this request is approved, the Alternative Education for Disruptive Youth (AEDY) and the Student Assistance Program (SAP) forms will be requested. Best practice is to have both forms completed as soon as possible to avoid any delay in processing the interim placement.
Student Information
Student Name: Student ID#:
School: Grade:
Check one: Regular Education: Special Education:
Incident Details
Rule Violation/s:
Please provide a summary of the incident:
Have any victims been identified? Yes No
If yes, please provide details:
Were there any injuries as the result of this incident? Yes No
If yes, please provide details and attach any documentation of medical treatment:
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