Forms → All Staff

Staff

Accounting
Authorization for Consultant/Independent Contractor (Vendor) Services	66 K	280-49
Authorization for Employee Use of Overtime	74 K	280-19
Checklist for Verification of Electronic Payment Information Change Requests	88 K	280-52
CONTRACT REVIEW FORM	88 K	203-6
Control Sheet -Check Issuance	105 K	280-27
Customer Receipt Confirmation	37 K	275-8
Executive Staff Expenditure Reimbursement Request	46 K	203-4
Justification	200 K	235-3
MCPS Deposit Log	101 K	280-92
Monthly Statement of Mileage for Use of Private Vehicle	77 K	220-2
Non-Teaching Long-Term Substitute Request	144 K	430-22
Personal Property Claim Form	83 K	525-6
Purchasing Card Cardmember Transaction Log	432 K	234-21
Purchasing Card File Maintenance Worksheet	79 K	234-20
Purchasing Card: Approving Official Acknowledgement	67 K	234-22
Receipt and Bond Form for Equipment Loan	419 K	234-23
Receipt for Donated Items	57 K	275-7
Record of Funds Transmitted to Montgomery County Public Schools	101 K	280-45
Request/Accounting for Nonlocal Travel Funds	145 K	281-1
Request/Authorization for Movement of Funds and/or Positions	92 K	210-1
Response Form for Required Criminal Background Checks	54 K	235-40
Small High School Support Compensation Assignment Form	77 K	203-8
Telephone Toll Record	104 K	202-3
ADAAA Accommodations
Binocular Disorder Questionnaire	78 K	272-7A
Emergency Evacuation Accommodations	50 K	336-2
EMPLOYEE REQUEST FOR ADA ACCOMMODATION	445 K	270-6
Benefits
Accelerated Tuition Reimbursement Process Verification	94 K	445-46
Acknowledgement of Medicare Enrollment Requirements for All Disability Retirees	32 K	455-14
Application for Lump Sum (De minimis) Retirement Distribution	72 K	455-26
Attending Physician's Statement	112 K	455-25
Certification for Transfer of Service Credit	98 K	450-4
Change in Personal Information for MCPS Employees	462 K	445-1A
Designation of Beneficiary/Beneficiaries	426 K	455-5
Employee Benefit Plan Enrollment	168 K	455-20
Flexible Spending Account Election	88 K	450-3
MCPS Retirement §403(b) Leave Payout Contribution Agreement	79 K	455-28
MCPS Retirement, Section 457(b) Leave Payout Contribution Agreement	80 K	455-29
Membership Information Montgomery County Public Schools Employee Pension System	434 K	455-3
Montgomery County Education Association (MCEA) Unit Member Moving Pay (Article 21.F) Verification Form	76 K	430-52
Optional Dependent Term Life Insurance	103 K	450-2
Optional Employee Term Life Insurance	100 K	450-1
PACS TIMESHEET Missed Duty-Free Lunch (MCEA Only)	70 K	430-14
Preliminary Application for Disabiity Benefit	89 K	455-23
Request for Estimate of Retirement Benefits	63 K	455-2A
Request for Leave under the Maryland Healthy Working Families Act	64 K	430-1B
Request for Refund of MCPS Prepaid Benefits	68 K	455-4
Retiree Benefit Plan Enrollment - FOR NEW RETIREES ONLY	186 K	455-22R
Retiree Benefit Plan Enrollment (2023)	145 K	455-22
RETIREE BENEFIT PLAN ENROLLMENT 2022	137 K	455-22 (2022)
Statement of Disability and Medical Release	82 K	455-24
Student Debt Relief Fund for SEIU Local 500 Bargaining Unit Members	108 K	442-1
Transfer of Cumulative Sick Leave	81 K	430-62
Tuition Reimbursement Appeal	80 K	445-45
Board of Education
Financial Disclosure Statement for Calendar Year ______ (For Board Members)	411 K	281-52
Bullying
Bullying, Harassment, or Intimidation Incident School Investigation Form	142 K	230-36
Bullying, Harassment, or Intimidation Reporting Form	179 K	230-35
Discrimination, Harassment, and Workplace Bully Complaint	103 K	230-39
Complaint
Administrative Complaint	503 K	430-42
Data Request
Request for an Internal Data Collection Activity	117 K	226-21
Request for Information or Support	65 K	365-54
Educational Services
Addendum To MCPS Forms	53 K	336-01
Appeal of Attendance Recording	421 K	560-26A
Application for Admission of Exchange Students in MCPS	444 K	335-66
Application for Interim Instructional Services, Administrative Placement	490 K	311-15A
Application for Partial Tuition Waiver for Regional Summer School Courses	457 K	325-4
Application for Partial Tuition Waiver of Student Online Learning Credit Courses	437 K	325-4B
Application for Partial Waiver of Summer Online Pathway to Graduation (OPTG) Tuition	422 K	325-4A
Application Form for Community Peers	102 K	335-47
Assistive Technology Family Loan Agreement	49 K	336-17
Attendance Intervention Plan	448 K	560-26B
Authorization for Assessment	78 K	336-31
Authorization for Release/Exchange of Confidential Information	101 K	336-32
Authorization for Section 504 Evaluation	48 K	270-2a
Behavioral Intervention Plan (BIP)	170 K	336-65
Bilingual Assessment Team Referral	68 K	336-26a
Bilingual Assessment Team Referral	65 K	336-26c
Bilingual Assessment Team Referral for Special Education Assessment(s)	59 K	336-26b
Binocular Disorder Questionnaire	78 K	272-7A
Bridge Plan for Academic Validation	434 K	320-15
Career and Technology Education (CTE) Programs Summer Experience Verification	455 K	560-60
Classroom Observation	226 K	336-21
Consent for Group Counseling	457 K	339-2
Consent for Individual Counseling	457 K	339-1
Distribution of Section 504 Plan	39 K	270-2D
Documentation of Parent/Guardian Agreement to Delay Initial Evaluation	35 K	336-46A
Dual Credit Refusal Form	89 K	280-93
Early College Program Withdrawal Form	41 K	280-94A
Educational History	156 K	336-20
Educational Management Team (EMT) Summary	53 K	272-4
Educational Management Team Program Plan for Students Being Retained	426 K	272-42
Elementary Teacher Report	146 K	272-7
Eligibility Screening Parent Interview/Questionnaire	175 K	336-22
Emergency Evacuation Accommodations	50 K	336-2
Emergent Multilingual Learners (EMLs)Accommodations Plan for Instruction and State Assessments	52 K	320-53
Emotional Disability	124 K	336-67
Five-Day Disclosure Notice of Documents Provided to Parent/Guardian for Review at an IEP Meeting	339 K	336-39A
Five-Day Extenuating Circumstances Notice of Documents Provided to Parent/Guardian for Review at an IEP Meeting	339 K	336-39C
Five-Day Opt Out Disclosure Notice on Documents Provided to Parent/Guardian at an IEP Meeting	338 K	336-39B
Five-Day Verification Notice of Documents Provided After an IEP Meeting	415 K	336-39D
Functional Behavioral Assessment (FBA)	185 K	336-64
G Suite for Education: Additional Services	439 K	271-2
Grade Report for Elementary School Students (Grades K–5) Receiving Interim Instructional Services	433 K	311-34A
Grade Report for Secondary School Students (Grades 6–12) Receiving Interim Instructional Services	417 K	311-34
High School Apprenticeship or Internship Program Counselor Recommendation Form	462 K	280-91A
High School Apprenticeship or Internship Program Teacher Recommendation Form	468 K	280-91B
History of Early Interventions	475 K	335-83
Homeless Student Transportation Action Request (HSTAR)	1,884 K	335-77B
Instructional Music Application	34 K	334-7
McKinney-Vento Eligibility and Best Interest Determination	55 K	335-77
MCPS Referral for OT/PT Review/Assessment	58 K	336-27
Mealtime Plan of Support	90 K	336-69
Move-in Preschool Child Find Questionnaire	449 K	335-49A
Multidisciplinary Evaluation Report for Students Suspected of Having a Specific Learning Disability	418 K	336-41c
Parent Letter: Recommended School	54 K	335-77A
Parent Report	35 K	336-39
Parent/Guardian Notification	469 K	335-84
Physical Disabilities Program Motor Characteristics Checklist	81 K	336-24
Prekindergarten Observation	83 K	336-21A
Prekindergarten Record of ESOL Closure, Kindergarten Only	413 K	335-41A
Prekindergarten Teacher Questionnaire	518 K	272-1
Prekindergarten/Head Start Checklist for Applications	476 K	335-9E
Prekindergarten/Head Start Parent/Guardian Volunteer Form	876 K	335-9D
Pre-Kindergarten/Head Start Speech-Language Screening Instrument	197 K	335-37
Preschool Child Find Questionnaire	483 K	335-49
Project Discovery Summer School Registration	54 K	325-5PD
Referral for Alternative Program Placement	1,230 K	336-55
Referral for Consultation for Early Childhood Services	51 K	337-12
Referral for ESOL Counseling	66 K	335-60
Request for a De-identified Naviance Student Account	419 K	427-1
Request for MCPS Course Credit in High School Mathematics	438 K	345-44
Request for Private Therapeutic Services in School	456 K	273-2
Request For Written Translations	77 K	311-1
Review of Home Instruction Program	455 K	270-35
School Truancy Referral	61 K	560-11
Secondary School Support Programs	51 K	325-10
Secondary Teacher Report	176 K	272-8
Section 504 Causation Meeting Form	84 K	270-2E
Section 504 Evaluation	85 K	270-2b
Section 504 Plan	181 K	270-2
Section 504 Progress and Accommodation Review Worksheet	137 K	270-2c
Special Education Staffing Notes	91 K	336-52
Speech-Language Screening Summary	85 K	336-25
Student Record Transmittal	65 K	336-37
Student Referral to the CREA Program	476 K	280-82
Summer School Diploma Card	54 K	226-1
Teacher Referral	178 K	272-9
Teacher Report for Quarterly Progress	443 K	272-5
Teacher Report for Quarterly Progress	443 K	272-6
Team Consideration of External Report	46 K	336-68
Transfer Request for MCPS Service School Assignment for Parentally-Placed Private/Parochial School Students with a Disability	38 K	336-16
Electronic Services
Electronic Payments Request	88 K	540-2
G Suite for Education: Additional Services	439 K	271-2
Request for ActiveSync	8 K	271-8
Request for an MCPS Account	504 K	271-4A
Web Services Request	97 K	271-5
Webmaster Account Request	53 K	271-7
Enrollment
Annual Notice for Directory Information and Student Privacy	72 K	281-13
Annual Notice for Directory Information and Student Privacy for Innovative School Year Calendar Schools	101 K	281-13ISC
Application for Early Entrance Kindergarten Program	586 K	271-6
Application for Early Entrance, First Grade Program	48 K	271-1
Application Form for Community Peers	102 K	335-47
Authorization To Request/Release Student Records	45 K	550-2
Dental Health Form	41 K	525-17
Dental Permission Form for Prekindergarten/Head Start	468 K	525-17A
Determination of Residency and Tuition Status	482 K	335-73
Elementary Immersion Interest Form	0 K	306-1
Health Screenings	440 K	SR-5
Hearing and Vision Screening Notice to Parents/Guardians	433 K	567-3
History of Early Interventions	475 K	335-83
Maryland Department of Health Immunization Certificate	161 K	DHMH 896
Maryland DHMH Blood Lead Testing Certificate	876 K	DHMH 4620
Maryland Home Language Survey	43 K	335-41
Maryland State Department of Education Prekindergarten Experience	438 K	345-17
New Student Information	236 K	560-24
Parent Affidavit (for Evidence of Birth)	56 K	560-24A
Parent/Guardian Notification	469 K	335-84
Prekindergarten/Head Start Application Receipt	432 K	335-9A
Private/Parochial School Student Referral for Special Education Services	74 K	336-13
Project Discovery Summer School Registration	54 K	325-5PD
Quick Guide to Enrollment	106 K	560-24B
Receipt for Prekindergarten Pilot (Pre-K+) Application	473 K	335-9B
Shared Housing Disclosure	68 K	335-74
Student Emergency Information	84 K	565-1
Student Record Card 5a, Additional Comments on Student's Health	410 K	SR-5a
Student Record Card 6 - Health Assessment	900 K	SR-6
Student's Personal Data	421 K	SR-1
Verification of Enrollment	167 K	226-19
Ethics
Employee Request for Religious Accommodation	78 K	270-7
Financial Disclosure Statement for Calendar Year ______ (For Staff)	91 K	281-51
Extended Leadership Program
The Extended Leadership Program Nominations/Request Form	40 K	430-96
Extracurricular Activities
Change to Annual Plan for Extracurricular Activities	91 K	430-58
Extracurricular Activity (ECA) Stipend Agreement and Assignment	57 K	430-59
High Schools Extracurricular Activities Summer Athletic Practice	148 K	430-61
Middle School Extracurricular Activities Annual Plan	82 K	430-60
Facilities/Equipment Management
Computer Equipment Delivery Request	66 K	234-5
Delivery Request	47 K	234-9
Elementary Physical Education Indoor/Outdoor Equipment Status Report	351 K	345-23A
Facility Emergency Plan	152 K	236-5
Facility Project Request Form	141 K	230-27
Furniture/Equipment Inventory Property Report	142 K	234-17
Furniture/Equipment Inventory Property Report: Addition/Correction	58 K	234-18
PROCOM Repair Order	418 K	215-23A
Record of Maintenance Visits	428 K	230-10
Relocatable Classroom Request	55 K	281-5
Repair/Delivery Request	41 K	234-3
Statement of Piano Tunings and Repairs	88 K	235-34
Sustainability Action Plan	193 K	201-10
Voluntary Recycling Reporting Form	95 K	201-9
Field Trips/Student Travel
Approval for Extended Day, Out-of-Area, and Overnight Field Trips	460 K	210-4
Approval for June Field Trips	455 K	210-6
Emergency Plan for Field Trips	453 K	210-5
Field Trip Accounting	499 K	280-41
Parent/Guardian Approval for Trips	444 K	560-31
Parent/Guardian Approval for Trips	435 K	555-6
Parent/Guardian Approval MCPS Virtual Field Trip/Program Addendum	473 K	210-7
School Bus Disciplinary Report	75 K	555-3
Food Services
Child Care Food Program Cycle Menus and Change Request	77 K	240-53
Child Care Food Program Menu	51 K	240-55
Child Care Food Program—Infant Menu	55 K	240-56
Monthly Invoice-Child and Adult Care Food Program	47 K	240-54
Notice of Change in Enrollment Child and Adult Care Food Program	169 K	240-50
Permanent Agreement Between Sponsoring Organization	70 K	240-51
Pre-Approval Visit Certification, Child Care Food Program	47 K	240-57
Summary Report of Child Care Food Program Home Review	50 K	240-52
Summary Report of Monthly Claim Discrepancies – Child Care Food Program	93 K	240-58
Forms
Accelerated Tuition Reimbursement Process Verification	94 K	445-46
Request for Interpretation Services	324 K	311-10
Request for Non-crisis OSFSE Services	431 K	551-1
Request to Telework	79 K	425-58
Return to Work Evaluation for Temporary Employees	186 K	440-40T
Staff Self-Reporting of Arrests, Criminal Charges, and Convictions	73 K	230-41
State of Maryland, Consent for Release of Information	197 K	DHR 1279A
Tuition Reimbursement Appeal	80 K	445-45
Grant
Authorization for School Grant Application	96 K	280-60
Information on School-Based Small Grant Award	8 K	280-71A
Health/Safety
Authorization to Provide Gastrostomy Tube Feeding	87 K	525-15
Behavior Threat Assessment Team Confidentiality and Non-Disclosure Agreement Regarding Student Records	446 K	236-11
Bloodborne Pathogens Post-Exposure Report	69 K	230-33
Building Sevices Indoor Air Quality Checklist	166 K	230-24
Certification of Physician or Health Care Provider	86 K	440-35
Crisis Center Referral Information	89 K	560-10
Emergency Care Plan	448 K	345-14
Emergency Care Plan SUMMER ONLY	446 K	345-14S
Emergency Preparedness Drills	517 K	236-3
Extended School Year (ESY) Emergency Plan	447 K	336-47
Facility Emergency Plan	152 K	236-5
Family Child Care Enrollment Application	58 K	240-62
Family Life and Human Sexuality (FLHS) and Disease Prevention and Control (DPC) Worksheet Annual Report—Elementary School	355 K	345-30a
Family Life and Human Sexuality (FLHS) and Disease Prevention and Control (DPC) Worksheet Annual Report—High School	273 K	345-30c
Family Life and Human Sexuality (FLHS) and Disease Prevention and Control (DPC) Worksheet Annual Report—Middle School	272 K	345-30b
Health Care Professional's Written Opinion --Confidential	74 K	230-34
Health Requirements for MCPS Prekindergarten/Head Start Programs	430 K	567-1
Health Screenings	440 K	SR-5
Hearing and Vision Screening Notice to Parents/Guardians	433 K	567-3
Hepatitis B Virus Vaccination Authorization	78 K	230-32
Indoor Air Quality Complaint	48 K	230-23
Mandatory Hepatitis B Vaccine Declination Statement	66 K	230-31
Maryland Department of Health Immunization Certificate	161 K	DHMH 896
Maryland DHMH Blood Lead Testing Certificate	876 K	DHMH 4620
Medical Card For Athlete	80 K	560-30
Parent/Child Reunification (PCR) - USE MCPS Form 565-1	467 K	236-1
Physical Education Short-term Illness or Injury Restriction Report	834 K	345-22
Report of Suspected Abuse and Neglect	98 K	335-44
Request for Health Information from Authorized Health Care Provider	449 K	567-2
Return to Work Evaluation: MCEA Employees	63 K	440-40M
Return to Work Evaluation: SEIU Employees	1,279 K	440-40S
School Emergency Plan	412 K	236-2
School Fire Evacuation Drill Log	453 K	230-1
Search and Seizure Report	498 K	236-6
Student Accident Report	79 K	525-2
Student Arrest on School Property	476 K	236-4
Student Record Card 5a, Additional Comments on Student's Health	410 K	SR-5a
Student Record Card 6 - Health Assessment	900 K	SR-6
Suicide Risk Reporting Form	130 K	335-54
Home and Hospital Teaching
Application for Home and Hospital Teaching, with Qualified Physical Health Condition ONLY	98 K	311-15B
Application for Interim Instructional Services, Administrative Placement	490 K	311-15A
Grade Report for Elementary School Students (Grades K–5) Receiving Interim Instructional Services	433 K	311-34A
Grade Report for Secondary School Students (Grades 6–12) Receiving Interim Instructional Services	417 K	311-34
Payroll Timesheet, Total Hours Summary Timesheet	103 K	311-19
Review of Home Instruction Program	455 K	270-35
Teacher's Biweekly Report of Interim Instructional Services	48 K	311-13
Time Report for MCPS Employees at NIH	37 K	430-78
Independent Activity Fund (IAF)
Attachment for MCPS Form 280-49A (IAF Funds)	16 K	281-49A
Authorization for Consultant/Independent Contractor (Vendor) Services	83 K	280-49a
Centralized Investment Fund Deposit/Withdrawal	55 K	280-44
Exception Request to Use Materials/Textbook Allocations for Furniture/Equipment Purchases	84 K	410-1
Fee Waiver Record	463 K	260-1
Field Trip Accounting	499 K	280-41
Independent Activity Fund (IAF) Remittance Slip	80 K	280-34
Independent Activity Funds Request for a Purchase	34 K	280-54
Independent Activity Funds Request for Payment to MCPS Employees for Services (Work) Performed	442 K	280-46
Independent Activity Funds Sponsor's Record	363 K	281-21
Independent Activity Funds Statement of Assets and Liabilities	457 K	281-24
Independent Activity Funds—Transfer	73 K	281-46
iPayment Worksheet— School Reimbursement for MCPS Substitute Teacher Coverage	152 K	203-2A
MCPS Deposit Log	101 K	280-92
Purchasing Card Cardmember Transaction Log	432 K	234-21
Purchasing Card File Maintenance Worksheet	79 K	234-20
Purchasing Card: Approving Official Acknowledgement	67 K	234-22
Receipt and Bond for Band/Orchestra Instruments	55 K	334-13
Receipt and Bond Form for Equipment Loan	419 K	234-23
Receipt for Donated Items	57 K	275-7
Request for Reimbursement of Invoices Paid by School	45 K	280-48
RESTRICTED INDEPENDENT ACTIVITY FUND (IAF) PURCHASES (OCFO)	99 K	281-53
RESTRICTED INDEPENDENT ACTIVITY FUND (IAF) PURCHASES (OOF)	83 K	281-55
Sale of Merchandise Analysis	481 K	281-22
Schedule of Accounts	452 K	281-23
Student Financial Obligation	110 K	560-4
Tickets and Cash Report of Admissions Manager	58 K	280-50
Yearbook Analysis	51 K	281-25
Interpretation Services
Pay Differential for Translation/Interpretation Services	78 K	430-53
Request for Interpretation Services	324 K	311-10
Leave Request
Leave Request (NOT Requiring ERSC Authorization)	67 K	430-1A
Leave Request (Requiring ERSC Authorization)	144 K	430-1
Professional Leave (PRO)	56 K	430-94
Library/Media/Technology
Evaluation and Selection of Instructional Materials Copyright Permission	94 K	203-1
MCPS Review of 30-Day Shelf Core Instructional Material	68 K	281-15
Media Purchase Order Professional Library	39 K	235-26C
Periodical Purchase Order (Professional Library)	40 K	235-26B
Record of Evaluation of Instructional Materials	123 K	365-25
Request for Professional Materials Reimbursement to MCPS Employees	31 K	365-41
Request for Waiver for the Instructional Use of Film	52 K	365-21
Payroll
Authorization for Employee Use of Overtime	74 K	280-19
Employee's Additional Withholding of Income Tax Agreement	249 K	280-3
Employee's Withholding Allowance Certificate	356 K	W4MW507
MCPS Employees’ Retirement/Pension System Maryland State Withholding Request	76 K	281-50
PACS Correction	139 K	280-7
PACS Time Sheet for Summer Supplemental Employment (SSE)	120 K	430-13
PACS Timesheet	156 K	430-70
PACS Timesheet Extracurricular Class 1 or Class 2 Activities	86 K	430-21
PACS Timesheet for Extracurricular Class 3–5 Activities, Dollars Only	32 K	430-18
PACS Timesheet Short-Term Substitute Teachers and Staff Development Substitute Teachers	109 K	430-17
PACS Timesheet Temporary Part Time	104 K	430-12
Payroll Timesheet, Total Hours Summary Timesheet	103 K	311-19
Request for Advanced Salary Placement	471 K	475-1
Teacher's Biweekly Report of Interim Instructional Services	48 K	311-13
Time Report for MCPS Employees at NIH	37 K	430-78
Personnel
Accelerated Tuition Reimbursement Process Verification	94 K	445-46
Addendum to Application for Retirement/Notice of Separation	454 K	455-2B
Administrative & Supervisory Position Advertisement Form	449 K	445-60
Administrative & Supervisory Position Interview Questions/Writing Prompt	435 K	445-63
Administrative & Supervisory Position Proposed Interview Panel	481 K	445-62
Administrative & Supervisory Proposed Candidates to Interview	437 K	445-61
Administrative & Supervisory Proposed Candidates, Interview Panel	66 K	445-61A
Administrative & Supervisory Recommendation to Hire	463 K	445-64
Annual Update of School Administrative Staff Contact Information	47 K	211-1
Application For Retirement	44 K	455-2
Application for: IRT/Resource Teacher/Counselor, Media Generalist, Counselor, Reading Specialist	167 K	430-47
Authorization Form Emergency Class Coverage Program—Support Staff	102 K	430-10S
Authorization Form Emergency Class Coverage Program—Teachers	97 K	430-10M
Authorization Form Volunteer Meeting Coverage Program—School Psychologists	70 K	430-10SP
Behind-the-Wheel Evaluation and Evacuation Proficiency	109 K	215-41
Change in Personal Information for MCPS Employees	462 K	445-1A
Change in Personal Information for MCPS Retirees and Former Employees	81 K	445-1B
Clearance Form for Central Office (CESC) Staff	34 K	220-3
Coach Evaluation Form	152 K	565-13
Drugs/Alcohol Reasonable Suspicion Documentation Form for Physical Evidence	140 K	338-2
Employee Change Request	79 K	426-1
Employee Emergency Contact/Information	32 K	565-10
Evaluation Form: Supporting Services Professional Growth System	112 K	430-90
Final Evaluation Report: Instructional Specialist	509 K	425-44
Final Evaluation Report: Speech-Language Pathologist	520 K	425-43
Final Evaluation Report: Assistant Principals, Assistant School Administrators, and Coordinators of School-Based Programs	451 K	430-80
Final Evaluation Report: Business and Operations Administrators	119 K	430-95
Final Evaluation Report: Central Services Administrators	175 K	430-74
Final Evaluation Report: Counselor	523 K	430-45
Final Evaluation Report: High School Resource Teacher	519 K	425-48
Final Evaluation Report: Library Media Specialist	514 K	430-79
Final Evaluation Report: Middle School Content Specialist	194 K	425-56
Final Evaluation Report: Middle School Team Leader	513 K	425-57
Final Evaluation Report: Montgomery County Infants and Toddlers (MCITP) Early Interventionists	509 K	425-49
Final Evaluation Report: Occupational/Physical Therapist	517 K	425-46
Final Evaluation Report: Principals	428 K	430-69
Final Evaluation Report: Pupil Personnel Worker (PPW)	555 K	425-42
Final Evaluation Report: Reading Specialist	514 K	425-51
Final Evaluation Report: Resource Counselor	514 K	425-47
Final Evaluation Report: School Psychologist	511 K	425-45
Final Evaluation Report: Social Worker	508 K	425-55
Final Evaluation Report: Staff Development Teacher (SDT) (.5 and above)	515 K	425-40
Final Evaluation Report: Teacher	519 K	425-39
High School Extracurricular Activity Summer Athletic Practice—Employee Eligibility Verification	86 K	430-97
Job Banding Career Advancement	97 K	336-84
Long-Term Teacher Substitute Assignment	83 K	445-17
Non-Teaching Long-Term Substitute Request	144 K	430-22
Notice of Separation/Termination of Employment from Montgomery County Public Schools	299 K	480-4
Notification of Assignment/Hours Paraeducators	51 K	447-6-PARA
Notification of Change in Hours/Title	48 K	447-6
Paraeducator Staffing Grid for SY 2017-2018	1,153 K	425-9A
Position Change	94 K	447-13
Reasonable Suspicion Behavior/Incident Documentation Form	128 K	338-1
Recommendation for Social Worker Position	221 K	430-92
Reference for Applicant for: IRT/Resource Teacher (Secondary), Resource Counselor, Media Specialist, Counselor, Reading Specialist	113 K	430-48
Request for Approval of Higher Level Assignment (HLA)	109 K	430-24
Request for Outstanding Service Award	102 K	460-9
Request for Temporary Employment	846 K	460-2
Request to Review Personnel File	132 K	425-8
Return to Work Evaluation: MCEA Employees	63 K	440-40M
Return to Work Evaluation: SEIU Employees	1,279 K	440-40S
Statement of Military Service	53 K	455-18
Student Teacher/Intern Assignment Verification	462 K	440-12
Substitute Teacher Removal Request	48 K	445-18
Summary of Employee Conference	54 K	425-54
Supporting Services Involuntary Transfer Request	90 K	425-9
Teacher Assignment	41 K	440-6
Tuition Reimbursement Appeal	80 K	445-45
Verification of Employment	50 K	460-29
Prekindergarten/Head Start
Customer Satisfaction Survey	492 K	335-92
Dental Health Form	41 K	525-17
Dental Permission Form for Prekindergarten/Head Start	468 K	525-17A
Health Requirements for MCPS Prekindergarten/Head Start Programs	430 K	567-1
Hearing and Vision Screening Notice to Parents/Guardians	433 K	567-3
History of Early Interventions	475 K	335-83
Maryland Department of Health Immunization Certificate	161 K	DHMH 896
Maryland DHMH Blood Lead Testing Certificate	876 K	DHMH 4620
New Student Information	236 K	560-24
Parent/Guardian Notification	469 K	335-84
Prekindergarten/Head Start Application Receipt	432 K	335-9A
Prekindergarten/Head Start Checklist for Applications	476 K	335-9E
Prekindergarten/Head Start Parent/Guardian Volunteer Form	876 K	335-9D
Prekindergarten/Head Start Programs School Year 2024–2025 List of Documents	52 K	335-9C
Receipt for Prekindergarten Pilot (Pre-K+) Application	473 K	335-9B
Request for Health Information from Authorized Health Care Provider	449 K	567-2
Request for Transportation Services	447 K	335-82
Student Emergency Information	84 K	565-1
Student Record Card 6 - Health Assessment	900 K	SR-6
Professional Development
Administrative and Supervisors' Professional Development Plan (PDP)	119 K	425-50
Continuing Professional Development (CPD) Request	458 K	440-8
End of PDP Cycle Review Form	91 K	425-37
Five-Year Certificate Renewal Plan for Renewal for the Standard Professional Certificate (SPC2) to Obtain the Advanced Professional Certificate (APC)	473 K	440-36
Five-year Certificate Renewal Plan for Renewal of the Advanced Professional Certificate (APC)	455 K	440-37
MCPS Counselor Certification Renewal Requirement (Lauryn’s Law)	109 K	425-41A
Professional Development Plan (PDP)	138 K	425-35
Progress Check Point	90 K	425-36
School Counselor Professional Development Plan (PDP)	507 K	425-41
Supporting Services Professional Development Plan (PDP)	89 K	425-53
Professional Growth System
Administrator Summary Report in Lieu of a Formal Observation	76 K	430-82
Evaluation Form: Supporting Services Professional Growth System	112 K	430-90
Final Evaluation Report: Athletics Specialist—High School	894 K	430-98
Final Evaluation Report: Instructional Specialist	509 K	425-44
Final Evaluation Report: Speech-Language Pathologist	520 K	425-43
Final Evaluation Report: Assistant Principals, Assistant School Administrators, and Coordinators of School-Based Programs	451 K	430-80
Final Evaluation Report: Business and Operations Administrators	119 K	430-95
Final Evaluation Report: Central Services Administrators	175 K	430-74
Final Evaluation Report: Counselor	523 K	430-45
Final Evaluation Report: High School Resource Teacher	519 K	425-48
Final Evaluation Report: Library Media Specialist	514 K	430-79
Final Evaluation Report: Middle School Content Specialist	194 K	425-56
Final Evaluation Report: Middle School Team Leader	513 K	425-57
Final Evaluation Report: Montgomery County Infants and Toddlers (MCITP) Early Interventionists	509 K	425-49
Final Evaluation Report: Occupational/Physical Therapist	517 K	425-46
Final Evaluation Report: Principals	428 K	430-69
Final Evaluation Report: Pupil Personnel Worker (PPW)	555 K	425-42
Final Evaluation Report: Reading Specialist	514 K	425-51
Final Evaluation Report: Resource Counselor	514 K	425-47
Final Evaluation Report: School Psychologist	511 K	425-45
Final Evaluation Report: Social Worker	508 K	425-55
Final Evaluation Report: Staff Development Teacher (SDT) (.5 and above)	515 K	425-40
Final Evaluation Report: Teacher	519 K	425-39
Post-Observation Conference Report	73 K	425-38
Reference for Entry-Level Assistant Principal Pool	850 K	445-25
Reference for Entry-Level Assistant School Administrator Pool	117 K	445-26
Teacher Summary Report in Lieu of a Formal Observation	76 K	430-99
Project Evaluation
Request for Project Evaluation or Outcome Reporting	42 K	370-1
Records
ACCUPLACER Score Request Form	40 K	320-14
Affidavit: Children in Informal Kinship Care	61 K	334-17
Annual Notice for Directory Information and Student Privacy	72 K	281-13
Central Records Storage/Shredding Request Form	114 K	365-10
Eligible Student Declaration Form	31 K	281-12
Maryland Department of Health Immunization Certificate	161 K	DHMH 896
Maryland DHMH Blood Lead Testing Certificate	876 K	DHMH 4620
Maryland Student Exit Record	81 K	SR-7
Official Transcript Online Pathway to Graduation Program	60 K	325-26
Outdoor Environmental Education Programs (OEEP)	62 K	345-6A
Prekindergarten Record of ESOL Closure, Kindergarten Only	413 K	335-41A
Request for MCPS Course Credit in High School Mathematics	438 K	345-44
Shared Housing Disclosure	68 K	335-74
Student Emergency Information	84 K	565-1
Student Records Review and Update Verification Certification Statement	107 K	226-7
Summer School Diploma Card	54 K	226-1
Summer School Report Card, Grades K-5	27 K	325-14
Residency Verification
Documentation of Residency Through Home Visit	434 K	560-34
Shared Housing Disclosure	68 K	335-74
Risk Management
Property Damage/Loss Claim Form	82 K	525-7
Request for Certificate of Insurance	79 K	203-7
Safety and Security
Behavior Threat Assessment Team Confidentiality and Non-Disclosure Agreement Regarding Student Records	446 K	236-11
Milestone Video System Access Request Form	452 K	222-21
Request to View MCPS Security Camera Video	105 K	236-12
Student Arrest on School Property	476 K	236-4
Student
ACCUPLACER Score Request Form	40 K	320-14
Affidavit: Children in Informal Kinship Care	61 K	334-17
Appeal of Attendance Recording	421 K	560-26A
Application for the Recovery and Academic Program (RAP)	452 K	335-75
Athletic Roster: Middle Schools	428 K	345-45
Athletic Roster: High Schools	56 K	345-45A
Attendance Intervention Plan	448 K	560-26B
Authorization for Section 504 Evaluation	48 K	270-2a
Behavior Threat Assessment Team Confidentiality and Non-Disclosure Agreement Regarding Student Records	446 K	236-11
Bullying, Harassment, or Intimidation Incident School Investigation Form	142 K	230-36
Bullying, Harassment, or Intimidation Reporting Form	179 K	230-35
Career and Technology Education (CTE) Programs Summer Experience Verification	455 K	560-60
Children in Informal Kinship Care Relationships	455 K	560-40A
Children in Out-of-County Living Arrangements	458 K	560-40
Distribution of Section 504 Plan	39 K	270-2D
Documentation of Interventions	95 K	272-10
Dual Credit Refusal Form	89 K	280-93
Educational Management Team (EMT) Summary	53 K	272-4
Eligible Student Declaration Form	31 K	281-12
Enrollment of Child in Maryland State-Supervised Care and Transfer of Educational Records	67 K	560-35
G Suite for Education: Additional Services	439 K	271-2
Gang-Related Incident Investigation Form	99 K	230-38
Gang-Related Incident Reporting Form	102 K	230-37
High School Internship Program Agreement	49 K	280-77
Intake Form: Supporting Student Gender Identity	85 K	560-80
Move-in Preschool Child Find Questionnaire	449 K	335-49A
Notice of High School Course Mark Exclusion	77 K	560-55
Parent/Child Reunification (PCR) - USE MCPS Form 565-1	467 K	236-1
Physical Education Short-term Illness or Injury Restriction Report	834 K	345-22
Preschool Child Find Questionnaire	483 K	335-49
Protection of Pupil Rights Amendment (PPRA)	395 K	PPRA
Recovery and Academic Program (RAP) Consent for Services and Authorization for Release of Confidential Information	463 K	335-75A
Request for a De-identified Naviance Student Account	419 K	427-1
Request for Approval of Part-Time Daily Attendance	459 K	280-98
Request for Approval to Complete a Course for Credit (CR)/No Credit (NC) in High School Credit Courses	84 K	270-32B
Request for Private Therapeutic Services in School	456 K	273-2
Request for Student Labels or Listings	174 K	226-10
Request to Review High School Transcript	83 K	355-27C
School Bus Disciplinary Report	75 K	555-3
School Hosted Student Service Learning (SSL) Opportunity—During the School Day or Virtual/Remote	81 K	560-59
School Truancy Referral	61 K	560-11
Secondary Grade Modification	452 K	355-27A
Secondary School Support Programs	51 K	325-10
Section 504 Causation Meeting Form	84 K	270-2E
Section 504 Evaluation	85 K	270-2b
Section 504 Plan	181 K	270-2
Section 504 Progress and Accommodation Review Worksheet	137 K	270-2c
Shared Housing Disclosure	68 K	335-74
Student Accident Report	79 K	525-2
Student Emergency Information	84 K	565-1
Student Records Review and Update Verification Certification Statement	107 K	226-7
Student Referral	61 K	555-1
Student Sign In/Sign Out Sheet	101 K	560-1
Student Transfer Outside of MCPS or Death of Student	463 K	565-5
Suicide Risk Reporting Form	130 K	335-54
Summer RISE 2020 Parent/Guardian Consent Agreement	453 K	496-1
Summer RISE 2020 Student Agreement	455 K	496-3
Summer School Report Card, Grades K-5	27 K	325-14
Worksheet for Suspension or Health-Related Exclusion	60 K	560-6
Student Internships
High School Apprenticeship or Internship Program Counselor Recommendation Form	462 K	280-91A
High School Apprenticeship or Internship Program Teacher Recommendation Form	468 K	280-91B
High School Apprenticeship Program Application, Parent/Guardian Consent Form	90 K	280-99A
High School Internship Program Agreement	49 K	280-77
Intern Performance Evaluation	438 K	360-30
Internship Sponsor Questionnaire	827 K	280-77A
Student Technology
G Suite for Education: Additional Services	439 K	271-2
Student Withdrawal
Authorization To Request/Release Student Records	45 K	550-2
Educational Interview for Withdrawal Prevention	152 K	565-4a
Elementary Student Withdrawal/Clearance	162 K	560-20
Secondary Student Withdrawal/Clearance Form	168 K	560-21
Student Permanent Withdrawal	189 K	565-4
Teacher
Application to Supervise a Counseling Practicum Student or Intern	435 K	440-12A
Authorization Form Emergency Class Coverage Program—Teachers	97 K	430-10M
Deletion of Student Service Learning (SSL) Hours Attached to Courses	69 K	560-54
Elementary Physical Education Teacher Data Sheet	168 K	345-31
General Use Slip	24 K	275-2
Model Rocket Activity Authorization	87 K	201-11
Montgomery County Education Association (MCEA) Unit Member Moving Pay (Article 21.F) Verification Form	76 K	430-52
Professional Reference (For Summer School Teacher)	461 K	325-21
Request for Advanced Salary Placement	471 K	475-1
Request for Assignments	80 K	301-2
Summary of Parent Conference	62 K	270-1
Summer School Report Card, Grades K-5	27 K	325-14
Teacher Volunteer Planning Center	69 K	311-52
Verification of Equivalent Activities for Advanced Professional Certificate (APC) Renewal Purposes	452 K	440-34
Volunteer Sign-In Log	46 K	311-56
Weekly Record of Time of Staff Arrival and Departure	241 K	430-11
Yearly Evaluation Report	87 K	430-66
Training
In-Service Attendance Report	126 K	215-39
Registration for Building Service Staff Inservice Training	45 K	440-18
Registration for Support Service In-service Training	43 K	440-4
Request for Released Time to Attend Class for Supporting Services Staff	88 K	440-21
Translations
Request For Written Translations	77 K	311-1
Transportation
Bus Accident Reporting Checklist	457 K	215-51
Defects School Bus Inspection	300 K	215-12
Foster Student Transportation Action Request (FSTAR)	1,884 K	336-42A
MCPS Vehicle Accident Report	2,495 K	215-49
Notice of Violation	80 K	215-14
Preventative Maintenance/Service	1,169 K	215-23
PROCOM Repair Order	418 K	215-23A
Request for Transportation Services	447 K	335-82
School Bus Disciplinary Report	75 K	555-3
Student Transportation Action Request Form (STAR)	1,884 K	336-42
Union
12-month MCEA Members Designation of Annual Leave to Contribute to 403(b) Plan	128 K	430-91
Emergency SEIU, Local 500, Child Care Reimbursement Form	57 K	441-1
MCAAP/MCBOA Members Designation of Annual Leave to 403(b)/457(b) Plan Contribution or Cash Payout	99 K	430-91B
MCAAP/MCBOA/MCPS Grievance Form	443 K	430-43
MCEA Grievance Form	89 K	430-41
Montgomery County Education Association (MCEA) Unit Member Moving Pay (Article 21.F) Verification Form	76 K	430-52
Request for MCBOA Masters Salary Supplement	551 K	430-39
Request for Use of ESR Overtime	75 K	280-21
Return to Work Evaluation: MCEA Employees	63 K	440-40M
Return to Work Evaluation: SEIU Employees	1,279 K	440-40S
SEIU Local 500 Sick Leave Bank Opt Out	75 K	280-38
SEIU LOCAL 500/MCPS Grievance	118 K	430-40
SEIU/MCPS Emergency Assistance Program	556 K	430-25
Student Debt Relief Fund for SEIU Local 500 Bargaining Unit Members	108 K	442-1
Union Business Leave (UBL)	76 K	430-5