SUPTS. MEMO. NO. 35
May 31, 1996
|FROM:||William C. Bosher, Jr.
Superintendent of Public Instruction
|SUBJECT:||Forms for the 1996-97 School Session|
Enclosed is a requisition to facilitate your request for certain forms that are furnished by the Department of Education for use in your schools during the 1996-97 school year. The completed requisition should be mailed in time to arrive on or before June 30, 1996, to: Mr. Howard D. Ruffner Warehouse Manager Department of Education P. O. Box 2120 Richmond, Virginia 23218-2120 Should you have any questions, please contact Mr. Ruffner at (804) 786-2835. WCBJr/pfm Enclosure: A copy of this memo and its attachment will be sent to the superintendent's office BBA.023 USE THIS FORM TO ORDER ONLY THE ITEMS LISTED BELOW _______________ Date VIRGINIA DEPARTMENT OF EDUCATION REQUISITION FOR CERTAIN FORMS DEC-1 Driver Education Certificate _____ HPE-h9 Virginia Physical Inspection of Students _____ HPE-h12 School Entrance Health Information Form _____ LE.005 Cumulative Physical Fitness Record _____ LF.012a Summary of Physical Fitness Ratings _____ Teacher's Report to Principal (Revised 1990) LF.009 Cumulative Health Record _____ LF.010 Summary of Physical Defects and Corrections _____ (Teacher/Nurse Report to Principal) LF.011 Summary of Physical Defects and Corrections _____ (Principal's Report to Division Superintendent) PA No.1 Principal's Record of Attendance _____ PA No.2 Principal's Monthly Report to Superintendent _____ (25 Sets Per Pad) pads PA No.3 Principal's Summary of Monthly Reports _____ S-2 Principal's Term Report _____ T-25 Teacher's Register _____ SNP-12 Daily Record of Operation (Revised 1995) _____ (20 Sheets Per Pad - One Per School) A.C.020 Food Production Records _____ (100 Sheets Per Pad) pads MCH-213C School Entrance Physical Examination and _____ Immunization Certification Health Form BBA.023 Page Two (When ordering School Food Service Brochures, please order by whole package) School Food Is Good ... Brochure _____ (250 per package) pkg. Tell Me About School Meals: Answer for _____ Parents ... Brochure (250 per package) pkg. We Are Pleased To Provide Meals for School _____ Personnel ... Brochure pkg. (250 per package) Get In Step With Breakfast ... Brochure _____ (50 per package) pkg. ___________________________________________ Contact Person: ___________________________________ Signature, Division Superintendent _____________________ ___________________________________ Printed Name County, Town, or City _____________________ ___________________________________ Telephone Number Address (Street Address if possible) ___________________________________ City and Zip Code