District Forms & Notices

Most of the forms and notices listed below are PDF files. To view or print these files, you must have Adobe Acrobat Reader on your computer. If you don't already have it, you can download it for FREE from the Adobe Website.

Printable Forms

District Forms

• Fundraising Approval Form
• FOIL - Request for Public Access to Records
  Form should be returned to Natasha Walkowicz (nwalkowicz@pjschools.org), Public Records Access Officer, Port Jervis School District, 9 Thompson Street, Port Jervis, NY 12771
• Adult Release Form | Minor Release Form
• Hold Harmless Agreement
• Volunteer Application Form
• Substitute Renewal Form

Food Service

• Application for Free & Reduced Lunch

Health

• Medication Release Form
• Athletic Interval Health Form
• Athletic Health History Form
• 2021-2022  High-Risk Medical Exemption Form for Home Instruction

Student Registration

• Affidavit - Select appropriate form
  • Parental
  • Custodial
  • Living with Others
• Affidavit of Property Owner/Landlord
• Application for Free & Reduced Lunch
• Parent Portal & Student Portal Form

Technology

• Student Permission Form/Internet User Policy
• Student Wi-Fi Use Agreement

Transportation

2023-2024 School Year

• Bus Permission Form for Pre-Kindergarten/Kindergarten/1st Grade Students
• Babysitter Form
• Transportation Request to Private School

2024-2025 School Year

• Bus Permission Form for Pre-Kindergarten/Kindergarten/1st Grade Students
• Babysitter Form
• Transportation Request to Private School

Working Papers

• New Jersey
• New York

Addtional Forms

• College Service Request - This is for college students looking to do observations in our classrooms

Public Notices

• Access to High School Student Information by Military Recruiters
• Student Privacy and Disclosure Information (FERPA)
• Pesticide Use
• About Asbestos
• Right to request information about teacher qualifications
• Web Site Accessibility Statement
• Parents Bill of Rights for Data Privacy and Security
  • Appendix to Parents Bill of Rights for Data Privacy
• Section IX Athletics - Spectator Code of Conduct
• Board Policy 3420 - Non-Discrimination and Anti-Harassment in the School District
• Board Policy 3421 - Title IX and Sex Discrimination
• Workplace Violence Prevention Program

More Information

Can't Find What You're Looking for?

Contact your school's Main Office or District Office
Email:
accessibility@pjschools.org

District Policies