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Forms and Other Useful Information for Parents
Click on the name of the form you need.  The format for each document is indicated.  Documents labeled PDF require Adobe Acrobat Reader, which can be downloaded free of charge.  Documents labeled .doc are created with Microsoft Word and will require Word or a compatible program to open.

Parents Guide to Special Education (This is a large file and may take several minutes to download depending on your connection speed.)

Use the application supplied here if you wish to give notice of your intention to provide home instruction to your child(ren).  For more information about home schooling, contact Denechia Edwards.

Homeschool Application (Word document) 

Homeschool Application (PDF) 

Cell Phone Use  (.doc)

Student Transfer Request   (.doc)

Student Transfer Request Letter (.pdf)
(Use this form if you do not have Microsoft Word on your computer.)

Student Permission to Publish to Internet  (.doc)

School Entrance Health Form  (.pdf) and Instructions
State law requires that your child is immunized and receives a comprehensive physical examination before entering public kindergarten or elementary school.  Part I of the form is to be completed by the parent or guardian and Part II and Part III must be completed by a Medical Provider. This form must be completed no longer than 12 months before your child's entry into school. The Code of Virginia does not extend a grace period of complying with this regulation. (Please note that the results of a comprehensive physical examination may be accepted if not reported on MCH 213F but MUST contain the elements prescribed by the State Health Commissioner.)

Information Necessary for Pupil Enrollment in a Virginia Public School 
This site provides more detailed information regarding requirements to enroll a student in a Virginia public school.


Certain prescribed immunizations are required for a child to enroll or attend public school in Virginia as outlined in School & Day Care Minimum Immunization Requirements, Virginia Department of Health. ( http://www.vdh.state.va.us/Epidemiology/Immunization/documents/Min%20Requirements.pdf)

Parents are responsible for providing documentation that all required immunizations are up-to-date and completed, or that a medical or religious exemption has been obtained. These include the required doses of DTaP (diphtheria, tetanus, pertussis), polio, hepatitis B, MMR (measles, mumps, rubella) and varicella.

A child whose immunizations are incomplete may be admitted conditionally, provided the parent or guardian has documentation at the time of enrollment indicating that the child has received at least one dose of the required immunizations and has a written schedule for completing the remaining doses within 90 calendar days of the opening of school.

Due to the extended interval required between Hepatitis B vaccine doses, the conditional enrollment period is 180 calendar days. Please note the 180 day conditional enrollment period only applies to the Hepatitis B vaccine.

The 90-day grace period does not apply to the Tdap booster as outlined below (Code of Virginia § 22.1-271.2B).  Since the start of the 2006-2007 school year, a booster dose of pertussis-containing vaccine (Tdap) has been required for students entering the sixth grade, unless the student has had a tetanus-containing vaccine within the last five years or has a medical or religious exemption. There is no grace period for compliance with this requirement because Tdap is a single dose vaccine, not a series.

Beginning with the 2009-2010 school year, a complete series of three doses of Human Papillomavirus vaccine (HPV) is required for female students (COV § 32.1-46). The first dose shall be administered prior to entering the sixth grade. Unlike any other required vaccine, after reviewing educational materials approved by the Board of Health, the parent or guardian, at the parent’s or guardian’s sole discretion, may elect for the child not to receive the HPV vaccine.

Parents/guardians of rising sixth-grade girls are requested to provide the school with documentation of HPV vaccine administration if the student receives the immunization. If the parent/guardian opts not to have his/her daughter vaccinated, DCPS does not require parents/guardians to sign a waiver form and no documentation is needed. Sixth-grade girls who do not have proof of HPV vaccine administration will not be excluded from school. These guidelines apply only to the HPV vaccine.



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