Miscellaneous Forms

Car Accident Report Form

Report Form for Secondary Schools

Disciplinary Action Forms

        Elementary (English version)
        Elementary (Spanish version)
        Secondary (English version)
       
Secondary (Spanish version)

Evacuation Site License Agreement for Schools

License Agreement Sample Letter

Opt Out Forms

Elementary & Junior High for Internet, Media & Directory Information
Senior High for Internet, Media, Directory Information & Military Recruiters 

Optional Student Travel Planning Guides

Step-By-Step Guide for Planning In-State/Single Day Trips
Step-By-Step Guide for Planning Overnight/Out-of-State Trips

Permit to Leave Elementary School Grounds

Permit to Leave Elementary School Grounds During School Hours

Power of Attorney Forms - English Versions

Joint Custody
Sole Custody

Power of Attorney Forms - Spanish Versions

Joint Custody
Sole Custody

 Statements of Awareness for Students

        Intermediate Level Elementary (English version)
        Intermediate Level Elementary (Spanish version)
        Secondary (English version)
       
Secondary (Spanish version)

Student Form for Delegation of Rights

Delegation of Right to Make Educational Decisions 

Student Observation Form Letter

Letter Format

Policy-Related Forms

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 Audit Dept. Intranet site for School Support Organization forms.
   
SECTION D:  
DJH-R-F Corporate Card Cardholder Responsibilities and Agreement
   
SECTION E:  
EBA-R-F Emergency Response and Incident Command Procedures - School Emergency Response Plan
EDB-F Equipment Transfer Form (See Property Management Intranet site.)
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:  
GBCA-F Notice of Conflict of Interest Memorandum
GBCB-R-F(1) Annual Statement of Understanding (For All Employees)
GBCB-R-F(1)S Annual Statement of Understanding (For All Employeees) - Spanish Version
GBCB-R-F(2) Statement of Awareness - Classified Employee
GBCB-R-F(2)S Statement of Awareness - Classified Employee - Spanish Version
GBCB-R-F(3) Statement of Awareness Addendum - Classified Employee
GBCB-R-F(3)S Statement of Awarness Addendum - Classified Employee - Spanish Version
GBCB-R-F(4) Statement of Awareness - Certificated Employee
GBCB-R-F(5) Statement of Awareness Addendum - Certificated Employee
GBCB-R-F(6) Statement of Awareness - Classified Director
GBCB-R-F(7) Statement of Awareness - Classified Supervisor
GBCB-R-F(8) Statement of Awareness Addendum - Classified Director or Supervisor
GBCB-R-F(9) Statement of Awareness - Certificated Administrator
GBCB-R-F(10) Statement of Awareness -Specialist
GBCB-R-F(11) Statement of Awareness Addendum - Administrator/Specialist
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
GCBA-R-F(1) Acknowledgement of Conditions of Employment for Contract Employee Receiving Retirement Benefits
GCBA-R-F(2) Acknowledgement of Conditions of Employment for Part-Time Employee Receiving Retirement Benefits
GCD-R-F Loyalty Oath – Professional Staff
GCPA-R-F(1) RIF Teacher Profile 2011-12
GCPA-R-F(2) RIF Counselor Profile 2011-12
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
GDBA-R-F(1) Retiree Return to Work Form for Full-Time Employee Receiving Retirement Benefits
GDBA-R-F(2) Retiree Return to Work Form for Part-Time Employee Receiving Retirement Benefits
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 (fillable form)
GDPD-R-F(2) Employee Letter of Reprimand: District Level (fillable form)
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 Teacher
   
SECTION I:  
IGBF (ADE form #1) Primary Home Language Other Than English (PHLOTE) Home Language Survey
IGBF (ADE form #2) Parental Waiver Application
IGBF (ADE form #3) Parent Request for Student Withdrawal from an English Language Learner Program
IGBH-R-F(1) Checklist for Referral of a Special Education Student to a Focus School/Alternative Program
IGBH-R-F(2) Checklist for Special Education Student to Return from a Focus SchoolAlternative /Program
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(2) Athletics Physical Form (Part A)
IGDJ-R-F(2) Athletics Health History Form (Part B)
IIAB-R-F Request for Lost/Damaged Textbook Fine Waiver
IIBE-F Off-Air Video Tape Request Form
IICA-R In-State/Single Day Travel Planning Guide
IICA-R Out-of-State/Overnight Travel Planning Guide
IKE-R-F(1) Letter to Parents re: Promotion/Retention of Kdg Students
IKE-R-F(1)S Letter to Parents re: Promotion/Retention of Kdg Students - Spanish Version
IKE-R-F(2) Letter to Parents re: Promotion/Retention of 1st-6th Gr Students
IKE-R-F(2)S Letter to Parents re: Promotion/Retention of 1st-6th Gr Students - Spanish Version
IKE-R-F(3) Promotion/Retention Form - MPS Record of Student Progress and Grade Placement
IKE-R-F(3) Promotion/Retention Form - MPS Record of Student Progress and Grade  Placement (This is a "fillable" version that can be completed on the computer.)
IKE-R-F(3)S Promotion/Retention Form - MPS Record of Student Progress and Grade Placlement - Spanish Version
IKF-R-F Alternative Graduation Requirements Appeal Form
IKG-R-F(1) Transcripts Evaluation
IKG-R-F(2) Course Challenge Test Application Form
INE-R-F Criteria for Performances and Presentations to Students
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 Animals in the Classroom - Parent Notification - Spanish Version
   
INDEX J:  
JB-R(1)-F Section 504 Complaint Form
JB-R(2)-F Complaint of Discrimination
JC-R-F(1) First ­ Request for Proof of Student Identity/Age
JC-R-F(2) Second Request for Proof of Student Identity/Age
JC-R-F(3) Open Enrollment Application Form
JC-R-F(5) Parental Acknowledgement of Responsibility for Part-Time Students
JC-R-F(6) Information for Host Parent Enrolling a Foreign Student Who Requires an I-20
JC-R-F(7) Caregiver & Living Arrangements Affidavit for Homeless or Abandoned Student
JC-R-F(7)S Caregiver & Living Arrangements Affidavit for Homeless or Abandoned Student (Spanish)
JC-R-F(8) Student Identity Affidavit
JC-R-F(9) Rights of Homeless Students
JC-R-F(9)S Rights of Homeless Students (Spanish)
JC-R-F(10) Student Residency Questionnaire (McKinney-Vento)
JC-R-F(10)S Student Residency Questionnaire - Spanish Version
JC-R-F(11) Homeless Student Dispute Resolution Forms
JC-R-F(12) Affidavit of Arizona Residency (Revised 12/14/11)
JC-R-F(12)S Affidavit of Arizona Residency - Spanish Version
JC-R-F(13) Affidavit of Shared Residence (Revised 12/14/11)
JC-R-F(13)S Affidavit of Shared Residence - Spanish Version
JEAA-R-F(1) Certificate of Chronic Health Condition
JEAA-R-F(1)S Certificate of Chronic Health Condition - Spanish Version
JEAA-R-F(2) Parent Notification of Chronic Health Condition Guidelines
JEAA-R-F(2)S Parent Notification of Chronic Health Condition Guidelines -Spanish Version
JEAA-R-F(3) Chronic Health Condition Eligibility Checklist
JEAA-R-F(4) Parent Notification of Child Placed on Chronic Health Conditions List
JEAA-R-F(4)S Parent Notification of Child Placed on Chronic Health Conditions List - Spanish Version
JEGA For the Affidavit of Intent for Home Schooling, see the Superintendent of Schools Web site.
JEGA-R-F(1) Information Sheet for Parents Instructing Their Child(ren) at Home
JEGA-R-F(2) Acknowledgement of Parental Awareness (re: Safety of Children Instructed at Home, But Enrolled Part-Time With District)
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 (Order form 94-80-54 D from MDC.)
JFD-R-F Harassment or Bullying Report (Sample - see below for Template)
JFD-R-F Harassment or Bullying Report - TEMPLATE
JFG-R-F Student Interview or Custody Transfer - For Investigation NOT Related to Child Abuse  [Use form JHG-R-F(2) for investigations related to child abuse.]
JFH-R-F Freedom of Religious Expression Complaint Form
JGD-F(2) Application for Readmission after Expulsion - Student Report
JGD-F(2)S Appliction for Readmission after Expulsion - Student Report - Spanish Version
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 Application for Readmission - Authorization to Release Confidential Information - Spanish Version
JGD-F(5) Application for Readmission - Conditions of Probation/Conditional Liberty
JGD-F(6) Student Readmission Agreement
JGD-F(6)S Student Readmission Agreement - Spanish Version
JHCD-R-F(1) Parent’s Consent for Giving Medication at School
JHCD-R-F(2) Individualized Health Care Plan
JHCD-R-F(3) Consent for Student Self-Administration of Medication or Dietary Supplement at School
JHCD-R-F(4) Medication Incident Report
JHCD-R-F(5) Field Trip Form for School Personnel Giving Medication in Absence of the School Nurse
JHCD-R-F(6) Student Overnight Travel Emergency and Medication Form
JHCD-R-F(6)S Student Overnight Travel Emergency and Medication Form - Spanish Version
JHCD-R-F(7) Release for Student to Carry Prescribed Inhaler or Emergency Medication
JHG-R-F(1) Child Abuse Report Form
JHG-R-F(2) Student Interview or Custody Transfer by Law Enforcement Officer for Child Abuse Investigation   [Use form JFG-R-F for an investigation that is NOT related to suspected child abuse.]
JHG-R-F(3) Child Abuse Report Status
JHG (CPS/DES  form sample) Sample of DES child abuse investigation form that a CPS Specialist may present to school staff member to access student records.
JHG (CPS/DES  form sample) Sample of DES child abuse investigation form that a CPS Specialist 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(2) Financial Questionnaire for Waiver/Reduction of Student Fee or Material Usage Charge
JO-R-F Parent Authorization for Disclosure or Release of Educational Records
JO (other) Request for Records (by student, parent, or legal guardian)
   
SECTION K:  
KBA-F Request for Public Records of the School District
KBAA-F Request to Withdraw from Activities or Classes
KG-R Permit for Use of School Facilities (Use form 94-26-25 W from MDC.)
KH-R-F Gift/Donations Acceptance Form (Use form 94-54-01 W from MDC.)
KI Request to Distribute Flyers (See Community Relations Web site).
KLB-F Citizens Request for Reconsideration of Materials
   
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