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SUPTS. MEMO. NO. 25
May 29, 1998 |
| TO: | Division Superintendents |
| FROM: | Paul D. Stapleton
Superintendent of Public Instruction |
| SUBJECT: | Forms for the 1998-99 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 1998-99 school year. The completed requisition should be mailed in time to arrive on or before June 30, 1998, 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. PDS/fyt Enclosure: A hard copy of this memo and its enclosure 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 HPE-h9 Virginia Physical Inspection of Students _____ LE.005 Cumulative Wellness Related Fitness Record _____ 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 pads (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 _____ 8 1/2 x 11(100 Sheets Per Pad) pads A.C.020 Food Production Records _____ 8 1/2 X 14 (100 Sheets per Pad) pads MCH-213C School Entrance Physical Examination and _____ Immunization Certification Health Form (When ordering School Food Service Brochures, please order by whole package) ___________________________________________ Contact Person: _____________________________________ Signature, Division Superintendent _____________________ _____________________________________ Printed Name County, Town, or City _____________________ ____________________________________ Telephone Number Address (Street Address if possible) _____________________________________ City and Zip Code