Miscellaneous Forms | Formas Misceláneas

Evacuation Site License Agreement for Schools

License Agreement Sample Letter

Permit to Leave Elementary School Grounds

Permit to Leave Elementary School Grounds During School Hours | Autorización para Abandonar las Instalaciones de la Escuela Primaria

Photograph/Video Recording Consent Forms for Parents

          Consent for Use of Photographs | Consentimiento de uso de FotografÍas

          Consent for Release of Images | Consentimiento para la Liberación de Imágenes

Student Classroom Observation Agreement Forms

Request and Agreement for Classroom Observation by Parent | Solicitud y Acuerdo de los Padres para la Observación en el Salón de Clase

Request and Permission Agreement for Observation by Third Party (Non-Parent) | Solicitude de Observación Estudiantil y Acuerdo de Permiso

 

Additional "miscellaneous" forms for student matters (for example, power of attorney forms, parent consent to release of student information forms, transportation off campus, etc.) are available by selecting "Employees" above and then "Student Guidance Documents & Forms."

 

Policy-Related Forms | Formas Relacionadas con las Políticas

SECTION B:  
BBB-F Board Member Oath of Office
BBFA-F Board Member Conflict of Interest
BDC-F Executive Sessions
BDDH-F Request to Address the Board
BHE See Communications & Marketing for School Support Organization forms
   
SECTION D:  
DJH-R-F Corporate Card Cardholder Responsibilities and Agreement
   
SECTION E:  
EBA-R(1)-F Emergency Response and Incident Command Procedures - School Emergency Response Plan  (Click here for fillable form)
EBA-R(2)-F Drill Report  (Complete and submit using the OnBase system to report fire drills, lockdown drills & off-site evacuations. See Security for instructions.)
EDB-F Equipment Transfer Form (See Property Management)
EGAA-R-F(1) Copyright - Request for Permission to Reprint Copyrighted Material
EGAA-R-F(2) Copyright - Authorization to Reprint Copyrighted Material
EJ-R-F Report/Certificate of Records Destruction
   
SECTION G:  
GBA-R-F Equal Employment Discrimination/Retaliation Complaint Form
GBA-R-F(S) Formulario de Denuncia por Discriminación/Represalia de Igualdad en el Empleo
GBCA-R-F(1) Workplace Conflict of Interest Form (Nepotism)
GBCA-R-F(2) Financial Conflict of Interest Memorandum to Purchasing
GBCB-R-F(1) Annual Statement of Understanding (For All Employees) COPY ON WHITE PAPER ONLY
GBCB-R-F(1)S Declaración Anual de Entendimiento (Para Todos los Empleados) - COPY ON WHITE PAPER ONLY
GBCB-R-F(2) Statement of Awareness - Classified Employee COPY ON WHITE PAPER ONLY
GBCB-R-F(2)S Declaración de Conocimiento de PolÍticas, Procedimientos y Reglamentos - Empleado Clasificado - COPY ON WHITE PAPER ONLY
GBCB-R-F(3) Statement of Awareness Addendum - Classified Employee 
GBCB-R-F(3)S Suplemento a la Declaración de Conocimiento - Empleados Clasificados 
GBCB-R-F(4) Statement of Awareness - Certificated Employee COPY ON WHITE PAPER ONLY
GBCB-R-F(5) Statement of Awareness Addendum - Certificated Employee 
GBCB-R-F(6) Statement of Awareness - Classified Director COPY ON WHITE PAPER ONLY
GBCB-R-F(7) Statement of Awareness - Classified Supervisor COPY ON WHITE PAPER ONLY
GBCB-R-F(8) Statement of Awareness Addendum - Classified Director or Supervisor 
GBCB-R-F(9) Statement of Awareness - Certificated Administrator COPY ON WHITE PAPER ONLY
GBCB-R-F(10) Statement of Awareness - Specialist COPY ON WHITE PAPER ONLY
GBCB-R-F(11) Statement of Awareness Addendum - Administrator/Specialist
GBCX-R-F Complaint of Workplace Harassment
GBCX-R-F(S) Denuncia de Acoso en el Lugar de Trabajo
GBKB For Drug & Alcohol Testing Locations and Checklists, see the Human Resources Intranet site.
GBLA-F Authorization to Release Information
GBQB-F Copyright and Invention Assignment Agreement
GCD-R-F Loyalty Oath – Professional Staff
GCPA-R Classroom Teacher/Counselor/Student Advisor RIF Profile - Contact HR
GCPD-F(1) Employee Letter of Reprimand: Professional Staff
GCPD-F(1) Employee Letter of Reprimand: Professional Staff (Fillable form)
GCPD-F(2) Appeal of Letter of Reprimand: Professional Staff
GDD-R(1)-F(1) Support Staff Hiring – Background Investigation Form (Employer)
GDD-R(1)-F(2) Support Staff Hiring – Background Investigation Form (Personal)
GDD-R(1)-F(3) Support Staff Loyalty Oath
GDD-R(2)-F Support Staff Hiring – Fingerprint Requirements
GDPD-R-F(1) Employee Written Warning: Building/Unit Level 
GDPD-R-F(2) Employee Letter of Reprimand: District Level  
GDPD-R-F(3) Classified Personnel Appeal Form: Letter of Reprimand/Suspension With or Without Pay 
GEA-R-F(1)

Volunteer Application & Referral Forms

GEA-R-F(2) Field Experience Agreement for Volunteer
GEA-R-F(3) Certification of Classified Employee Regarding Volunteer Activity
GEA-R-F(4) Certification of Classified Employee Regarding Volunteer Coaching
GEC-F Field Experience Agreement for Student Practitioner
   
SECTION I:  
IGBF-R (ADE form #1) Primary Home Language Other Than English (PHLOTE) Home Language Survey | Idioma Principal en el Hogar excluyendo el inglés (PHLOTE) Encuesta sobre el Idioma en el Hogar 
IGBF-R (ADE form #2) Parental Waiver Application | Solicitud de Exención presentada por los Padres de Familia
IGBF-R (ADE form #3) Parent Request for Student Withdrawal from an English Language Learner Program | Solicitud de los padres para retirar a su hijo(a) de un programa para estudiantes que están aprendiendo el inglés
IGBF-R (ADE form #4) AZELLA Placement Test Referral Form (Moving from Mainstream to EL Services)
IGBH-R-F(1) Checklist for Referral of a Special Education Student to a Focus School/Alternative Program (To be updated by Special Education staff)
IGBH-R-F(2) Checklist for Special Education Student to Return from a Focus School/Alternative /Program (To be updated by Special Education staff)
IGDD-F Criteria for Performances and Presentations to Students
IGDF-R-F Activity/Fund Raising Request
IGDJ-R-F(1) Athletics Statement of Awareness
IGDJ-R-F(1)S Declaración de Concientización el Atletismo de MPS
IGDJ-R-F(2) (AIA form) Athletics Physical Evaluation Form (Part A)
IGDJ-R-F(2) (AIA form) Athletics Physical Examination Form (Part B)
IIAB-R-F Request for Lost/Damaged Textbook Fine Waiver
IIAB-R-F(S) Solicitud de Eximición de Mlta por Extravío/Daño de Libros de Texto 
IIBE-R-F Video Use Request (For videos not rated G or equivalent)
IICA-R In-State/Single Day Travel Planning Guide
IICA-R Out-of-State/Overnight Travel Planning Guide
IKE-R(1)-F(1) Letter to Parents re: Promotion/Retention of Kdg Students
  WORD version of letter
IKE-R(1)-F(1)S Carta a padres sobre: promoción/retención de estudiantes de kinder
  WORD version of letter
IKE-R(1)-F(2) Letter to Parents re: Promotion/Retention of 1st-6th Gr Students
  WORD version of letter
IKE-R(1)-F(2)S Carta a padres sobre: promoción/retención de estudiantes del 1st-6th grados
  WORD version of letter
IKE-R(1)-F(3) Promotion/Retention Form - MPS Record of Student Progress and Grade Placement
IKE-R(1)-F(3) Promotion/Retention Form - MPS Record of Student Progress and Grade  Placement (Fillable form)
IKE-R(1)-F(3)S MPS Registro del Progreso Estudiantil y Colocación de Curso
IKE-R(2)-F(1) Annual Notification Letter to Parents Regarding 3rd Grade Reading Level
IKE-R(2)-F(1)S Carta de notificación anual a padres con respecto al nivel de lectura del 3rd grado
IKE-R(2)-F(2) Letter from Principal to Parents of Student in Need of Extra Reading Instruction and Support
IKE-R(2)-F(2)S Carta del director a padres del estudiante que necesita instrucción adicional de lectura y apoyo
IKE-R(2)-F(3) Move on When Reading - Grades K-3 Student Academic Support Plan
IKF-R-F Alternative Graduation Requirements Appeal Form
IKF-R-F(S) Formulario de Apelación de Requisitos Alternativos de Graduación
IKG-R-F(1) Transcripts Evaluation (Fillable form)
IKG-R-F(1)S Transcripciones de Evaluaciones
IKG-R-F(2) Course Challenge Test Application Form (Fillable form)
IKG-R-F(2)S Formulario de Solicitud de Examen para la Comprobación del Curso
ING-R-F(1) Principal Approval Form for Animals in the Classroom
ING-R-F(2) Animals in the Classroom - Parent Notification
ING-R-F(2)S Notificación al Padre - Animales en el Salón de Clase


SECTION J:
JB-R(1)-F Section 504 Complaint Form
JB-R(1)-F(S) Formulario de Reclamos del Artículo 504
JB-R(2)-F Complaint of Discrimination
JB-R(2)-F(S) Denuncia de Discriminación
JC-R-F(1) First ­ Request for Proof of Student Identity/Age
JC-R-F(1)S Solititud de Prueba de Identidad/Edad
JC-R-F(2) Second Request for Proof of Student Identity/Age
JC-R-F(2)S Segunda Petición de Pruebea de Identidad/Edad
JC-R-F(3) Open Enrollment Application | Solicitud de Inscripción Abierta
JC-R-F(4) Principal's Letter to Family Member Enrolling Student Whose Custodial Parent Lives in U.S. - but not AZ (See below for Word version of letter)
JC-R-F(4) Word Version of JC-R-F(4) - Remember to enclose JC-R-F(15)
JC-R-F(4)S Carta del Director a un Miembro de la Familia que Inscribe a un Alumno Cuyo Padre con Custodia Vive en los Estadios Unidos - pero no en Arizona 
JC-R-F(5) Acknowledgement of Parental Responsibility for Part-Time Students
JC-R-F(5)S Reconocimiento de Responsabilidad Parental (para estudiante que está inscripto a tiempo parcial en clases)
JC-R-F(6) Information for Host Parent Enrolling a Foreign Student Who Requires an I-20
JC-R-F(6)S Información para Padres Anfitriones que Inscribena Estudiantes Extranjeros que Requieren el Formulario I-20
JC-R-F(7) Caregiver & Living Arrangements Affidavit for Homeless or Abandoned Student (McKinney-Vento) - for 2018-19 enrollment
JC-R-F(7)S Declaración Jurada del Que Cuida y Provee Vivienda para un Estudiante sin Hogar o Abandonado - for 2018-19 enrollment 
JC-R-F(8) Student Identity Affidavit
JC-R-F(8)S Declaración Jurada de Identidad Estudiantil
JC-R-F(9) Rights of Homeless Students
JC-R-F(9)S Derechos de los Estudiantes sin Vivienda
JC-R-F(10) Student Referral Questionnaire (McKinney-Vento) - for 2018-19 enrollment
JC-R-F(10)S Cuestionario de Recommendación del Estudiante - for 2018-19 enrollment
JC-R-F(11) Homeless Children and Youth Dispute Resolution Forms
JC-R-F(11)S Formularios de Resolución de Disputas de Niños y Jóvenes sin Hogar
JC (sample) McKinney-Vento - Transportation Agreement
JC(S) (sample) McKinney-Vento - Convenio de Transporte
JC-R-F(12)

Arizona Residency Documentation Form

JC-R-F(12)S Formulario de Documentación de Residencia en Arizona
JC-R-F(13) Affidavit of Shared Residence
JC-R-F(13)S Declaración Jurada Sobre Residencia Compartida
JC-R-F(14) Affidavit of Arizona Residency for Close Relative Living With the Student
JC-R-F(14)S Declaración Jurada de Residencia de Arizona para Pariente Cercano Que Vive con el Estudiante
JC-R-F(15) Affidavit of Parent/Guardian Residing Outside of Arizona but in U.S. (used to request "best interest" waiver of tuition)
JC-R-F(15)S Declaración Jurada de Padres o Tutores que Residen Fuera del Estado de Arizona Pero Dentro de los Estados Unidos (utilizado para solicitar la exención de "mejor interés")
JC-R-F(16) Letter from Principal Declining Request for Waiver of Tuition
JC-R-F(16)S Carta del Director Rechazando la Solicitud de Exención de Matrícula
JEAA-R-F(1) Certificate of Chronic Health Condition - Contact School Health Office for this form.
JEAA-R-F(1)S Certificado de Condición Crónica de Salud - Pongase en contacto con la oficina de salud de la esculela para este formulario.
JEAA-R-F(2) Parent Notification of Chronic Health Condition Guidelines
JEAA-R-F(2)S Notificación a los Padres Acerca de las Normas de Condiciones de Salud Crónica 
JEAA-R-F(3) Chronic Health Condition Eligibility Checklist
JEAA-R-F(3)S Lista de Control de Elegibilidad por Enfermedad Crónica
JEAA-R-F(4) Parent Notification of Child Placed on Chronic Health Conditions List
JEAA-R-F(4)S Notificación a padres del niño colocado en la lista de condiciones de salud crónica
JEGA For the Affidavit of Intent for Home Schooling, see the Maricopa County School Superintendent website. | Para la declaración de intención de estudiar en el hogar, visite el sitio web del superintindente del Condado Maricopa.
JEGA-R-F(1) Information Sheet for Parents Instructing their Child(ren) at Home
JEGA-R-F(1)S Hoja Informativa para los Padres que Imparten Instrucción a sus Hijos en el Hogar
JEGA-R-F(2) Acknowledgement of Parental Awareness for Part-Time Students
JEGA-R-F(2)S Reconocimiento de Responsabilidad Parental (para estudiante que está inscripto a tiempo parcial en clases)
JFC-R-F(1) Student Conduct ­ Student Removal from Class
JFC-R-F(2) Notice to Principal of Refusal to Readmit Student
JFCC-R-F(1) School Bus Safety Program - Emergency Bus Evacuation Drill
JFCC-R-F(2) Bus Incident Referral to Administrator (Use form 94-80-54D from MDC)
JFD-R-F(1) Harassment Report (Fillable form)
JFD-R-F(1) Harassment Report (For completion by hand)
JFD-R-F(1)S Denuncia de Acoso (Forma rellenable)
JFD-R-F(1)S Denucia de Acosa (Para completar a mano)
JFD-R-F(2) Bullying Report (Fillable form)
JFD-R-F(2) Bullying Report (For completion by hand)
JFD-R-F(2)S Denuncia de Intimidación (Forma rellenable)
JFD-R-F(2)S Denuncia de Intimidación (Para completar a mano)
JFD-R-F(3) Notice of Appeal Rights: Complaint of Discrimination/Harassment Based on Race, Color, National Origin, Religion, Sex, or Disability
JFD-R-F(3)S Notificación de Derecho de Apelación Denuncia de discriminación/acoso basado en raza, color, origen nacional, religión, sexo o discapacidad
JFD-R-F(4) Notice of Appeal Rights: Bullying Complaint
JFD-R-F(4)S Notificación de Derecho de Apelación - Denuncia de Intimidación
JFD-R student pamphlet Student Bullying Notice/Pamphlet | Folleto Sobre los Niños Contra la Intimidación
JFG-R-F Student Interview or Custody Transfer - For Investigation NOT Related to Child Abuse  [To be completed law enforcement officers, probation officers, and representatives from other government agencies. For any investigation related to child abuse, use form JHG-R-F(2).] 
JFH-R-F Freedom of Religious Expression Complaint Form
JFH-R-F(S) Formulario de Quejada de Libertad de Expresión Religiosa
JGD-F(2) Application for Readmission after Expulsion - Student Report
JGD-F(2)S Suspensión/Expulsión de Estudiantes (Solicitud de Readmisión) Informe del Estudiante
JGD-F(3) Application for Readmission - Memo to Governing Board
JGD-F(4) Application for Readmission - Authorization to Release Confidential Information
JGD-F(4)S Suspensión/Expulsión de Estudiantes (Solicitud de Readmisión) Autorización para Divujlgar Información Confidential
JGD-F(5) Application for Readmission - Conditions of Probation/Conditional Liberty
JGD-F(6) Student Readmission Agreement
JGD-F(6)S Acuerdo de Readmisión
JHCD-R-F(1) Consent for School to Administer Medication or Dietary Supplement to Student and Authorization for Release of Health Information (Form 95-76-01 W)
JHCD-R-F(1)S Autorización para que la Escuela Administre Medicamentos o Suplementos Dietéticos a los Estudiantes y Autorización para Divulgar Información de Salud
JHCD-R-F(2) Individualized Health Care Plan - Contact School Health Office for this form.
JHCD-R-F(2)S Plan Individualizado de Atención Médica - Pongase en contacto con la oficina de salud de la esculela para este formulario.
JHCD-R-F(3) Consent for Student Self-Administration of Medication or Dietary Supplement at School
JHCD-R-F(3)S Consentimiento para la Autoadministración de Medicamentos o Suplementos Dietéticos en l Escuela
JHCD-R-F(4) Medication Incident Report
JHCD-R-F(6) Student Overnight Travel Emergency and Medication Form
JHCD-R-F(6)S Hoja de Emergencias y Medicamentos para el Estudiante Quedarse la Noche
JHCD-R-F(7) Release for Student to Carry Prescribed Inhaler or Emergency Medication
JHG-R   OnBase form

Child Abuse Report Form - enter http://Onbase.mpsz.org as URL on Internet Explorer  Form Completion Instructions

JHG-R-F(2) Student Interview or Custody Transfer by Law Enforcement Officer for Child Abuse Investigation  [To be completed by law enforcement officers investigating child abuse. DCS representatives should use the DCS form for student interviews. For investigations NOT related to child abuse, use form JFG-R-F.]

JHG (DCS form sample #1)

Sample DCS form - Request for Release of Education Records for  child abuse investigation
JHG (DCS form sample #2) Sample DCS form - Request for Release of Education Records for child abuse investigation (if student is ward of Court in legal care, custody and control of DCS)

JHG (DCS form sample #3)

Sample DCS form - Request for Interview at School for child abuse investigation
JHG (DCS form sample #4) Sample DCS form - Notice of Removal
JHG (SRPMIC form sample) Sample of Salt River Pima-Maricopa Indian Community CPS form that an investigator may present to school staff member to interview a student.
JN-F(1) Request for Waiver/Reduction of Student Fee or Material Usage Charge
JN-F(1)S Solicitud de Exención/Reducción de Cuota Estudiantil o Cargo por Uso de Materiales
JN-F(2) Financial Questionnaire for Waiver/Reduction of Student Fee or Material Usage Charge
JN-F(2)S Cuestionario Financiero para Eximir/Reducir las Cuotas Estudiantiles o los Cargos por Uso de Materiales
JO-R-F Parent Authorization for Disclosure or Release of Educational Records
JO-R-F(S) Autorización Parental para Divulgacion o Comunicación de Registros Educativos
JO  Request for Records (By parent, guardian, student over age 18)
JO-S Solicitud del Expediente Educativo (Padre, tutor legal, estudiante mayor de 18 años de edad)
   
SECTION K:
KBA-R-F Request for Public Records of the School District
KBA-R-F(S)  Solicitude de Registros Públicos del Distrito Escolar
KBAA-F Request to Withdraw from Activities or Classes
KBAA-F(S) Solicitud para Retirarse de Actividades o Clases
KH-R-F Gift/Donations Acceptance Form (Use MDC form 94-54-01W)
KLB-F Citizens Request for Reconsideration of Materials
KLB-F(S)  Solicitud de Ciudadanos de Reconsideracion de Materiales


SECTION L:
LC-F(1) Sample Letter to Researcher to Engage in Research
LC-F(2) Agreement While Conducting Research
LC-F(3) Permission to Engage in Research Form