About this Form
Form number: 311-15A
Audience: MCPS Staff
Last revised: August 2016
This form requests services through interim instructional services due to an administrative placement of a student. It should be completed and signed by an Associate Superintendent/designee and submitted to the Interim Instructional Services (IIS) Office in Room 251, CESC, or signed electronically and submitted (via the submit button on the form) to IISOffice@mcpsmd.org. For questions, contact the IIS office at 240-453-2470.
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* This form is not a fill-in form.