Roxbury School District Forms
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| District | High School | Eisenhower | Lincoln/Roosevelt |
| Franklin | Jefferson | Kennedy | Nixon |
District (Applies to all schools) |
|
Form Name |
Description |
| Anaphylaxis Action Plan | District wide form for students suffering from allergies |
| Asthma Treatment Plan | District wide form for students suffering from asthma |
| Babysitting/Daycare* | Request for babysitting/daycare transportation |
| Free/Reduced Lunch Application | Form for free or reduced lunch. |
| Free/Reduced Lunch Application (Spanish) | Form for free or reduced lunch. (In Spanish) |
| Genesis Parent Access Registration | Form to sign up for account for Genesis parent access |
| Harrassment/Intimidation/Bullying (HIB) Incident Report | Incident report for Harrassment/Intimidation/Bullying. |
| Health History * | Kindergarten/new student health history |
| Home Language Survey * | Home language survey |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| Medical Condition Update Form | Medical condition update form |
| Medication Permission Form | Permission slip for administering medication |
| Seizure Action Plan | District wide form for students suffereing from seizures |
| Self Administered Medication Form | Permission slip for self administering medication (not to be confused with the general permission slip for administering medication) |
| Strep Permission Form * | Strep testing permission form |
| Student Registration Form (3/17/11 version) |
Version date 3/17/11 |
* Forms required for Kindergarten registration.
High School |
|
| Form Name | Description |
| Athletic Sign up Forms | Athletic Participation Checklist, Physical Exams Forms, etc. |
| Class Restriction for Medical Reasons | Form for students who may have restrictions for certain classes due to health issues. |
| Code of Conduct Form | RHS Code of Conduct |
| Field Trip Permission | Blank permission slip for school field trips |
| Grades 5-12 Studnts AUP Agreement (Revised 07/31/2007 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Physical Education Restrictions | Form for students who may have restrictions for physical education |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
| Student Handbook | RHS Student Handbook |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
Eisenhower |
|
| Form Name | Description |
| Grades 5-12 Students AUP Agreement (Revised 07/31/2007 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
| Athletic Sign Up Forms | Athletic Participation Checklist, Physical Exams Forms, etc. |
Lincoln/Roosevelt |
|
| Form Name | Description |
| Cell Phone Form | Parent form for cell phone usage. |
| Code of Conduct | Code of Conduct - Student's Responsibilities |
| E-mail Sign up | Form to sign up for email notifications |
| Field Trip Permission | Permission slip for Lincoln/Roosevelt field trips |
| Grades 5-12 Students AUP Agreement (Revised 07/31/2007 version)) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Health Record Form | Universal child health physical form |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
| Grade 5 Supply List | List of materials and supplies for 5th grade students. |
| Grade 6 Supply List - A | List of materials for teachers - DeGregorio, Miller, Muller, Rodgers, Saul and Sumski |
| Grade 6 Supply List - B | List of materials for teachers - Bonis, Buchanan, Gaul, Osbun, Regner and Roy |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
Franklin |
|
| Form Name | Description |
| E-mail Sign up (08/24/07) | Form for signing up for email notification |
| Grades K-4 Code of Conduct (08/13/07 version) | Code of Conduct-Student's Responsibilities |
| Grades K-4 Students AUP Agreement (Revised 08/24/07 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
Jefferson |
|
| Form Name | Description |
| E-mail sign up | Form for signing up for email notification |
| Grades K-4 Code of Conduct (08/13/07 version) | Code of Conduct-Student's Responsibilities |
| Grades K-4 Students AUP Agreement (Revised 08/24/07 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| School Supply Lists (Aug. 2010) | List of school supplies needed for grades K - 4 |
| Allowable Foods for Distribution and Request for Addition | Information on Permittable Foods |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
Kennedy |
|
| Form Name | Description |
| E-mail sign up (08/24/07) | Form for signing up for email notification |
| Grades K-4 Code of Conduct (08/13/07 version) | Code of Conduct-Student's Responsibilities |
| Grades K-4 Students AUP Agreement (Revised 08/24/07 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| School Supply List | List of School supplies need for grades K-4 |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |
Nixon |
|
| Form Name | Description |
| E-mail Sign up (New 08/10/07) | Form to sign up for email notifications |
| Grades K-4 Code of Conduct (08/13/07 version) | Code of Conduct-Student's Responsibilities |
| Grades K-4 Students AUP Agreement (Revised 08/24/07 version) |
Acceptable Use Policy Agreement to use the Internet and District Network Resources |
| Student Supply List | Grades K-4 supply requirements |
| Media Consent Form (01/25/2007) | Parent Consent Form for Release of Student's Personal Information and/or Student's Written Work/Artwork for Press Release or on the School District's Websites |
| Student Registration Form (Revised 02/22/10 version) |
Version date 02/22/10 |