Park City School District
Park City School District
MENUMENU

Forms

 Title  Category  Modified  FormID         File       
Benefits Change Form Benefits 12/2/10 Benefits Change Form
Coordination of Benefits Benefits 12/2/10 Coordination of Benefits Form
Delta Dental Enroll Benefits 12/2/10 Delta Dental Enroll
Dental Cards Benefits 12/2/10 Dental Cards
Flex Spending Change of Status Benefits 12/2/10 Flex Change of Status
Meritain Enrollment Change Form Benefits 12/2/10 Meritain Enrollment Change Form
Opticare Enrollment Benefits 12/2/10 Opticare Enroll
Opticare Out-of-Network Reimbursement Benefits 10/18/11 Opticare Out of Network Reimbursement Form
Flex Benefits Changes to Eligible Over-the-Counter Drugs Benefits 10/25/11 Flex Changes to OTC Drugs
Flex Benefits Cafeteria Enrollment Packet Benefits 10/25/11 NBS Enrollment Packet
Flex Benefits Example Expenses Benefits 10/25/11 NBS Sample Expenses
Meritain Claim Form Benefits 7/6/12 Medical Claim Form
Prescription Drug Coverage and Medicare Benefits 7/10/12 Medicare Coverage
Opticare Change Form Benefits 12/17/12 Opticare Change
Opticare Network Benefits 12/17/12 Opticare Network
BOE Application Board 5/17/17 BOE Application
Chart of Accounts Business Admin 12/12/08 Chart of Accounts
Telephone Bid Form Business Admin 3/31/14 Telephone Bid Form
Mileage Expense Reimbursement Business Admin 1/3/18 DO-PY101 Mileage Reimbursement
Mileage Expense Reimbursement (type-in) Business Admin 1/3/18 DO-PY101 Mileage Reimbursement Excel
Sexual Harassment Video Sign-In Sheet District Admin 7/28/08 DO-DA100 Sexual Harassment Sign In
Sexual Harassment Complaint Form District Admin 7/28/08 DO-DA101 Sexual Harassment Form
Sexual Harassment Interviewer’s Checklist For Accused Complainant District Admin 7/28/08 DO-DA102 Checklist for Complaintant
Sexual Harassment Interviewer’s Checklist For Accused Perpetrator District Admin 7/28/08 DO-DA103 Checklist for Perpetrator
Sexual Harassment Interview Form District Admin 7/28/08 DO-DA104 Sexual Harrassment Interview
Student/Enrollment Count Reporting Forms School Admin 7/28/08 DO-SA100 Enrollment Count Report Forms
Aggregate Suspensions of >10 Days Per Year School Admin 7/28/08 DO-SA103 Aggregate Suspension
Enrollment Audit Entry Log School Admin 7/28/08 DO-SA104 Audit Entry Log
Enrollment Audit Exit Log School Admin 7/28/08 DO-SA105 Audit Exit Log
Cumulative File Access Log School Admin 7/28/08 DO-SA106 File Access Log
Employee Warning Notice School Admin 7/28/08 DO-SA107 Employee Warning
Educator Evaluation Formative Process School Admin 7/29/08 DO-SA102 Formative Process
Safe School Incident Reporting Instructions School Admin 7/29/08 Link https://risep.usurf.usu.edu/instructions
Safe School Resources School Admin 7/29/08 Link https://risep.usurf.usu.edu/ss-resources
Professional Leave Tracking Sheet School Admin 7/27/09 DO-SA101 Leave Tracking
Professional Leave Tracking Sheet (Excel) School Admin 7/27/09 DO-SA101 Leave Tracking Excel
Administrative Handbook School Admin 8/4/09 Admin Handbook
Safe School Incident Reporting Form School Admin 5/17/10 Link https://risep.usurf.usu.edu/instructions
Request for Permission to Use Certain Videotapes, DVDs and Movies Curriculum 7/28/08 DO-CU102 Media Permission
Request for Reconsideration of Library or Instructional Material Curriculum 7/28/08 DO-CU103 Library Material
USOE Core/Cactus Codes Curriculum 12/17/12 Link http://www.schools.utah.gov/CURR/main/Course-Codes-and-Approval.aspx
Professional Development Sign-In Sheet Curriculum 8/26/14 Sign-in Sheet
Dual Immersion “Opt Out” Curriculum 4/22/15 Dual Immersion Opt Out Form
Novel Approval Request Form Curriculum 9/24/15 DO-CU101 Novel Approval Form
Novel Approval Request Form (type-in) Curriculum 9/25/15 DO-CU101 Novel Approval Form Fill In
Professional Development Reflection Form Curriculum 4/5/17 Travel Reflection Form
New Course Proposal Form Curriculum 11/8/17 DO-CU100 New Course Proposal
Fee Waiver Documentation Form Fees/Waivers 7/7/15 DO-FW105 Fee Waiver Form
Community Service Assignment – Obligations, Appeals (English & Spanish) Fees/Waivers 7/7/15 Link to USOE Forms http://www.schools.utah.gov/law/Forms.aspx
Appeal of Community Service Assignment (English & Spanish) Fees/Waivers 7/7/15 Link to USOE Forms http://www.schools.utah.gov/law/Forms.aspx
Admin: Certification of Compliance Forms – District, Elementary, Secondary Fees/Waivers 7/7/15 Link to USOE Forms http://www.schools.utah.gov/law/Forms.aspx
Fee Waiver Application Decision and Appeal Form (English & Spanish) Fees/Waivers 9/13/17 Link to USBE Forms www.schools.utah.gov/policy/formsprocedures
Publication Release Form General 7/29/08 DO-GE105 Publication Release
Club Application and Charter General 7/29/08 DO-GE202 Club Application
Publication Release Form for Non-School District-Sponsored Special Event General 7/29/08 DO-GE203 Publication Release Non-School
Consent for Release/Exchange of Information General 7/29/08 DO-GE204 Consent Release Info
Graduation Credits Worksheet General 7/29/08 DO-GE206 Credits Worksheet
PCSD Data Request Form General 7/29/08 DO-GE207 Data Request
PCSD Records Request Form General 7/29/08 DO-GE208 Records Request
Translation Request Form General 7/29/08 DO-GE209 Translation Request
Request to Use School District Equipment Off Site – Employees General 7/29/08 DO-GE210 Equipment Checkout Employee
Equipment Checkout for Students General 7/29/08 DO-GE211 Equipment Checkout Student
Parent Permission for Services/Activities General 12/17/08 Activities
Areas/Neighborhoods General 2/23/10 DO-GE300 PC Areas
Ethnicity/Race Letter 2010 (for school secretaries) General 3/3/10 DO-GE301 Ethnicity Race for Sec
Ethnicity/Race Letter 2010 (district) General 3/3/10 DO-GE301 Ethnicity Race
Ethnicity/Race Letter 2010 in Spanish (for school secretaries) General 3/3/10 DO-GE301s Ethnicity Race Spanish for Sec
Ethnicity/Race Letter 2010 in Spanish (district) General 3/3/10 DO-GE301s Ethnicity Race Spanish
Document Request General 3/11/10 DO-GE211 Document Request
Field Trip Permission Form General 5/10/10 DO-GE200 Field Trip
Approval to Enroll General 12/15/10 DO-GE102 Approval to Enroll
Student Internet Acceptable Use Agreement General 5/20/11 DO-GE104 Internet Acceptable Use
Publication Release Form (Spanish) General 5/20/11 DO-GE105s Public Release Spanish
Field Trip Permission Form (Spanish) General 5/20/11 DO-GE200s Field Trip Spanish
Consent for Release/Exchange of Information (Spanish) General 5/20/11 DO-GE204s Consent for Release Info Spanish
Student Internet Acceptable Use Agreement (Spanish) General 5/26/11 DO-GE104s Internet Acceptable Use Spanish
Student Injury Report Form General 9/28/11 Student Injury Site
Purchasing Request Fillable General 8/28/12 Purchase Request Form
Purchasing Request Form Type Enabled General 8/28/12 Purchase Request Type
Acceptable Use Policy for Internet Access and Computer Use (Spanish) General 2/1/13 AUP PCSD Acceptable Use
Student Registration Form-Kindergarten General 4/9/13 DO-GE111 Kinder Registration
Student Registration Form-Kindergarten (Spanish) General 4/9/13 DO-GE111s Kinder Registration Spanish
Student Registration Form General 4/11/13 DO-GE101 Registration Form
Student Registration Form (Spanish) General 4/11/13 DO-GE101s Registration Form Spanish
Fund-Raising Project Application General 12/2/13 DO-GE205 Fund Raising
Athletic and Academic Student Travel General 1/13/14 DO-GE201 Student Travel
Board of Education Academic Seal Form General 5/23/14 DO-GE106 Academic Seal
GRAMA Request General 10/17/14 GRAMA Request
Acceptable Use Policy for Internet Access and Computer Use General 10/20/14 AUP Acceptable Use
Flyer/Poster Request General 4/30/15 Flyer/Poster Request
Student Residency Questionnaire General 5/4/16 DO-GE108 Homeless Questionnaire
Student Residency Questionnaire (Spanish) General 5/4/16 DO-GE108s Homlessness Spanish
Open Enrollment Form General 5/23/16 DO-GE107 Open Enrollment Form
FERPA Notification of Rights (Spanish) General 8/9/16 FERPA Ferpa Form 2016 Spanish
FERPA Notification of Rights General 8/9/16 FERPA FERPA Form 2016
Check Request General 1/12/17 Check Request
Employee Travel Request Form General 1/26/17 Employee Travel Request
PHLOTE Survey General 4/18/18 DO-GE102 Phlote Form
Proof of Residency Requirement Form General 4/27/18 DO-GE110 Proof of Residency
Proof of Residency Requirement Form (Spanish) General 4/27/18 DO-GE110s Proof of Residency-SP
Custodial Inspection Report Facilities 7/28/08 DO-FA100 Custodial Inspection
Request for Use of School Facilities Facilities 1/12/17 DO-FA101 Facility Request Form 
Eccles Center Facilities 5/16/17 Eccles Request
Substitute Teaching – New Employee Recommendation HR 7/29/08 DO-HR252 Substitue Recommendation
Worker’s Compensation Form HR 5/5/10 Workers Compensation Form
Request for Reconsideration of Classification Recommendation HR 10/22/13 Request for Reconsideration
Volunteer Services Information Form HR 11/17/15 DO-HR260 Volunteer Services Information
Volunteer Services – Reference Phone Interview Form HR 5/18/16 Volunteer Phone Reference
Administrative – Reference Phone Interview Form HR 5/18/16 DO-HR201 Admin Phone Reference
Licensed – Reference Phone Interview Form HR 5/18/16 DO-HR211 License Phone Reference
Classified – Reference Phone Interview Form HR 5/18/16 DO-HR221 Classified Phone Reference
Coaching – Reference Phone Interview Form HR 5/18/16 DO-HR231 Coach Phone Reference
Contracted Services – Reference Phone Interview Form HR 5/18/16 DO-HR241 Contracted Phone Form
Substitute Teaching – Reference Phone Interview Form HR 5/18/16 DO-HR251 Substitute Phone Reference
Classified – Employee Transfer Request HR 12/15/16 Classified Transfer Request
Employee Transfer/FTE Change Form HR 12/15/16 DO-HR101 Employee Change Form
Special Assignment Contract HR 1/17/17 DO-HR103 Special Assignment Contract
Substitute Evaluation Form HR 1/30/17 Substitute Evaluation
Classified – Professional Agreement HR 2/8/17 CPA 16-17
Licensed – Salary Schedule HR 6/21/17 FY18 Licensed Salary Schedule
Group Interview Team Confidentiality Agreement HR 6/27/17 Group Interview Team Confidentiality Agreement
Interview Team Confidentiality Agreement HR 6/27/17 Interview Committee Confidentiality Agreement
Licensed – Employee Transfer Request HR 8/6/17 Licensed Transfer Request
Request for Job Posting (type-in) HR 8/6/17 DO-HR100 Request for Job Posting
Business Administrator Contract HR 8/16/17 Business Administrator Contract
Superintendent Contract HR 8/16/17 Superintendent Contract
Licensed – Compensation Agreement HR 9/11/17 Licensed Compensation Agreement
Administrative – Professional Agreement HR 9/13/17 Admin Agreement 2017-2020
Classified – Compensation Agreement HR 9/20/17 Classified Compensation Agreement
Request to be Absent from Work Location HR 10/6/17 DO-HR102 Request to be absent from work
New Employee Employment Offer HR 10/24/17 New Employee Offer
Licensed – Professional Agreement HR 1/8/18 Licensed Professional Agreement
Administrative – Salary Schedule HR 7/6/18 FY19 Admin Salary Schedule
Classified – Salary Schedule HR 7/6/18 FY19 Classified Salary Schedule
Classified – Technology Salary Schedule HR 7/6/18 FY19 Tech Schedule
Payroll Change Form Payroll 7/29/08 DO-PY100 Payroll Change Form
Mileage Chart Between Schools Payroll 7/29/08 DO-PY102 Mileage Chart
Per Diem Payroll 6/28/18 Per Diem Check Request 7-1-18
USIIS Parent Permission Form Medical 7/28/08 USIIS Permission Form
USIIS Parent Permission Form (Spanish) Medical 5/20/11 USIIS Permission Form Spanish
Immunization Requirements for Enrollment Medical 4/24/14 Link Link
Immunization Requirements for Enrollment (Spanish) Medical 4/24/14 Link Link
Kindergarten Registration Health Requirements Medical 3/2/15 DO-MD103 Kindergarten Health
Kindergarten Registration Health Requirements (Spanish) Medical 3/2/15 DO-MD103s Kindergarten Health Spanish
Child Abuse/Neglect Reporting Form Student Services 7/29/08 DO-SS103 Child Abuse Report
Process for Exiting High School to attend Adult Education Student Services 7/29/08 DO-SS104 Exit High School
Parent Interview Student Services 7/29/08 DO-SS202 Parent Interview
Parent Interview Guide for Interpreters Student Services 7/29/08 DO-SS203 Parent Interview Guide
SST Problem Solving Worksheet Student Services 12/17/08 SST Problem Solving
Student Services Team Referral Student Services 12/17/08 SST Referral
ELL Qualification Form Student Services 2/9/10 ELL Qualification Form
Procedural Safeguards Student Services 1/4/11 Link Link
Procedural Safeguards (Spanish) Student Services 5/20/11 Link Link
Student Transition Planning Student Services 4/18/12 Student Transition
Home School Exemption Form Student Services 8/5/14 DO-SS101 Home School Exemption Form
Scram Form (type in) Student Services 12/17/14 DO-SS204 SCRAM
Referral for Special Ed Evaluation Grades 4-5 Student Services 1/25/16 4-5 SPED Evaluation
Referral for Special Ed Evaluation Grades K-3 Student Services 1/25/16 K-3 SPED Evaluation
504 Parent Notice Student Services 11/28/16 DO-SS102 Link
504 Parent Notice (Spanish) Student Services 11/28/16 DO-SS102s Link
Dual Enrollment Form Student Services 8/15/17 DO-SS100 Dual Enrollment
District Office Presentations Technology Needs Form Technology 11/21/08 DO-TC100 Technology Needs Form
PCEF Home Internet Application (Spanish) Technology 11/30/15 PCEF Home Internet Application Spanish
PCEF Home Internet Application Technology 11/30/15 PCEF Home Internet Application
Bus Routes Transportation 5/17/10
Pre-School/Kindergarten Transportation Authorization Form Transportation 9/2/11 Authorization Information
Código DE Conducta Para Viajar en Los Buses Escolares Transportation 9/6/11 CODIGO DE CONDUCTA PARA VIAJAR EN LOS BUSES ESCOLARES
PRE-ESCOLAR /INFORMACIÓN DE AUTORIZACIÓN PARA KINDERGARTEN Transportation 12/17/12 PCSD Authorization Info Spanish
MVR Transportation 6/3/15 Motor Vehicle Form
Ineligible/Space Available Student Information Transportation 8/8/17 TR-100 Ineligible Bus Space
Request for Transportation Change (type-in) Transportation 1/19/18 TR-101 Request for Transportation Change
Request for Transportation Change Transportation 1/19/18 TR-101 Transportation Change Form