Back-to-School Forms for Current or Admitted Pacific School Families
2021 Back-to-School Forms - DUE TUESDAY, AUGUST 10
1. Family Information Form - Online. Required for all families, including preschool. If multiple students are in one family, this form can be completed once.
2. Student Information Form - Online. Required for all families, including preschool. Complete a separate response for each student.
3. Household Income Category Form - Fillable PDF. Required for all K-6 families. Preschool families may skip this form. If multiple students are in one family, this form can be completed once. Submit to the office or email to cdarby@pacificesd.org. (Note: this form is critical for school funding. The information in the form is kept confidential.)
English Form English Instructions Spanish Form Spanish Instructions
4. After School Program Form(s) - all families should complete the appropriate form(s), even if they do not plan to use the program(s), in case of emergencies. More information about these programs is here. You may bring each form to the office or email to the staff member listed below.
5. School Picture Order Form - School picture day will be on Thursday, September 23. Use this form to order photos. Please submit a paper copy to the office.
6. Parents' Club Welcome Letter - for all families, including preschool. Please complete the fillable PDF and email to president@pacificschoolfoundation.org or deliver to the school office.
7. Field Trip Driver Form - Please complete the Google form. Then please provide the following: copies of your driver’s license, proof of insurance (the card you keep in your car is fine), and driving record from the DMV (available here: https://www.dmv.ca.gov/portal/dmv/detail/online/dr). Bring these documents to the office or email them to Amy at aglogvac@pacifices.org. All field trip drivers should also complete the Volunteer Agreement below.
8. Volunteer Agreement - Please complete the Google form if you volunteer in any capacity that involves observation of or engagement with students, such as driving for or chaperoning field trips, supervising the yard, or being a classroom volunteer. Then please bring a copy of your COVID vaccination card to the office or email it to Amy at aglogovac@pacificesd.org.
9. Dientes Community Dental will provide dental services to students on campus Thursday, September 30, 2021, and Thursday, March 10, 2022. If you would like your student to participate, please complete This Form, and submit a paper copy to the office.
2021-22 Welcome Letters
K-6 FoodLab Welcome Letter and Preschool FoodLab Welcome Letter - Important Information about school meals.
Preschool Welcome Letter
Kindergarten Welcome Letter
Grade 1 Welcome Letter
Grade 2 Welcome Letter
Grade 3 Welcome Letter
Grade 4 Welcome Letter
Grade 5 Welcome Letter
Grade 6 Welcome Letter
Rights, Responsibilities, and Information for Your Reference
Library Agreement and Checkout Policies
Annual Notice to Parents in English or Spanish
Internet Acceptable Use Policy and Agreement
Online School Handbook
Wellness Guidelines
1. Family Information Form - Online. Required for all families, including preschool. If multiple students are in one family, this form can be completed once.
2. Student Information Form - Online. Required for all families, including preschool. Complete a separate response for each student.
3. Household Income Category Form - Fillable PDF. Required for all K-6 families. Preschool families may skip this form. If multiple students are in one family, this form can be completed once. Submit to the office or email to cdarby@pacificesd.org. (Note: this form is critical for school funding. The information in the form is kept confidential.)
English Form English Instructions Spanish Form Spanish Instructions
4. After School Program Form(s) - all families should complete the appropriate form(s), even if they do not plan to use the program(s), in case of emergencies. More information about these programs is here. You may bring each form to the office or email to the staff member listed below.
- After Care Application and Expectations for Preschoolers. Email to sreynolds@pacificesd.org.
- Kinder Rec Application and Expectations for Kindergarteners. Email to rperez@pacificesd.org.
- Rec Application and Expectations for Kindergarten through Sixth Grade Students. Email to jcowley@pacificesd.org.
5. School Picture Order Form - School picture day will be on Thursday, September 23. Use this form to order photos. Please submit a paper copy to the office.
6. Parents' Club Welcome Letter - for all families, including preschool. Please complete the fillable PDF and email to president@pacificschoolfoundation.org or deliver to the school office.
7. Field Trip Driver Form - Please complete the Google form. Then please provide the following: copies of your driver’s license, proof of insurance (the card you keep in your car is fine), and driving record from the DMV (available here: https://www.dmv.ca.gov/portal/dmv/detail/online/dr). Bring these documents to the office or email them to Amy at aglogvac@pacifices.org. All field trip drivers should also complete the Volunteer Agreement below.
8. Volunteer Agreement - Please complete the Google form if you volunteer in any capacity that involves observation of or engagement with students, such as driving for or chaperoning field trips, supervising the yard, or being a classroom volunteer. Then please bring a copy of your COVID vaccination card to the office or email it to Amy at aglogovac@pacificesd.org.
9. Dientes Community Dental will provide dental services to students on campus Thursday, September 30, 2021, and Thursday, March 10, 2022. If you would like your student to participate, please complete This Form, and submit a paper copy to the office.
2021-22 Welcome Letters
K-6 FoodLab Welcome Letter and Preschool FoodLab Welcome Letter - Important Information about school meals.
Preschool Welcome Letter
Kindergarten Welcome Letter
Grade 1 Welcome Letter
Grade 2 Welcome Letter
Grade 3 Welcome Letter
Grade 4 Welcome Letter
Grade 5 Welcome Letter
Grade 6 Welcome Letter
Rights, Responsibilities, and Information for Your Reference
Library Agreement and Checkout Policies
Annual Notice to Parents in English or Spanish
Internet Acceptable Use Policy and Agreement
Online School Handbook
Wellness Guidelines
Other Forms - Please submit to the office as needed or requested.
Request Special Meals Form (English or Spanish)- Use this form to request special meal accommodations for your student; submit to Pacific School Office.
School Medication Authorization Form - Use this form to request designated school personnel to assist any student(s) who are required to take medication during the school day or on school field trips. Medication must be in original packaging with prescription or dosing information. Medication must be accompanied by the completed form with signed authorization from parent/guardian and health care provider.
Physician's Report for Kindergartners and New Students (English/Spanish) - This includes immunization records. Pacific Elementary School District adheres to all state immunization laws. For more information see www.shotsforschool.org.
Oral Health Assessment Form - English and Spanish All families must visit the dentist, complete an oral health assessment, and submit the form during the student's first year in public school.
Interdistrict Transfer Form - Use the interdistrct transfer form only if you are a returning student or have already been admitted to Pacific School.
Interest Form for Changing Programs - Use the appropriate interest form if you would like to change programs (Home Study, Independent Study, or Five-Day).
Request Special Meals Form (English or Spanish)- Use this form to request special meal accommodations for your student; submit to Pacific School Office.
School Medication Authorization Form - Use this form to request designated school personnel to assist any student(s) who are required to take medication during the school day or on school field trips. Medication must be in original packaging with prescription or dosing information. Medication must be accompanied by the completed form with signed authorization from parent/guardian and health care provider.
Physician's Report for Kindergartners and New Students (English/Spanish) - This includes immunization records. Pacific Elementary School District adheres to all state immunization laws. For more information see www.shotsforschool.org.
Oral Health Assessment Form - English and Spanish All families must visit the dentist, complete an oral health assessment, and submit the form during the student's first year in public school.
Interdistrict Transfer Form - Use the interdistrct transfer form only if you are a returning student or have already been admitted to Pacific School.
Interest Form for Changing Programs - Use the appropriate interest form if you would like to change programs (Home Study, Independent Study, or Five-Day).