|
SUPTS. MEMO. NO. 40
June 6, 1997 |
| TO: | Division Superintendents |
| FROM: | Richard T. La Pointe Superintendent of Public Instruction |
| SUBJECT: | Forms for the 1997-98 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 1997-98 school
year. The completed requisition should be mailed in time to
arrive on or before June 30, 1997, 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.
RTL/pfm
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
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 _____
8+ x 11 (100 Sheets Per Pad) pads
A.C.020 Food Production Records _____
8+ x 14 (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)
___________________________________________
Contact Person: _____________________________________
Signature, Division Superintendent
________________________ ___________________________________
Printed Name County, Town, or City
________________________ _____________________________________
Telephone Number Address (Street Address if possible)
________________________________
City and Zip Code