Forms

Notice of Suspension Form

New Course Proposal

Golden State Seal Merit Diploma Form

Suspected Child Abuse Report

Special Ed:
o Behavioral Emergency Report

o Confidential IEP File log

o SELPA Low Incidence Requisition form
o Records Release Data Collection form
o Section 504:ADA Complaint form

      o 504 Procedural Guide Revised April 2012
o 504 Parent Rights-English    o 504 Parents Rights-Spanish
o 504 Notes Page -4- English and Spanish
o 504 Meeting Form Page 1-English and Spanish
o 504 Meeting Form Page 2 English and Spanish

o 504 Meeting Form Page 3 (English and Spanish)

o 504 Assessment Plan Consent
o 504 Addendum

Release and Acceptance of Responsibility for School District Student Form AR 5141.4a

Computer System/Internet/Email Acceptable Use Agreement AR 6040/AR 6163.4 form

Permit to Film/Photograph Minors for Publication E 1111 English form
E 1111 Spanish form
Withold Authorizatoin to Film/Photgraph Minors AR 1111 English form
AR 1111 Spanish form

Caregiver’s Affidavit form AR 5111.11
Field Trips
o List of Required Forms (E 6153a)
o Request for Field Trip (E 6153c)
o Parent Permission for Student Participation in Off-Campus, School
Sponsored/School-Related Event
English (E 6153d)
Spanish (E6153d)

o Consent and General Release of Liability
English (E 6153e)
Spanish (E 6153e)

o Field Trip Roster of Participants
o Transportation of Pupils in Privately-Owned Vehicles (E 3540.2)
o Food Services Field Trip Lunches
o Transportation Request Form E 6153b

Health Services Forms
AB 1433 Assessment Waiver – Spanish

Medical Instruction with letterhead

Oral Health Letter – English – Spanish

Oral Health Assessment Form

Vision Referral with letterhead
Hearing Referral with letterhead

Pertussis letter to school employees

Nurses Beeper Assignments