Restricted Visitor Request
This form is required for individuals who are subject to visitor restrictions and are requesting permission to enter Special School District schools and buildings for a specific purpose or event. Please complete all required information and submit the form in advance of the requested visit. Submission of this form does not guarantee approval. All requests will be reviewed in accordance with District policies and procedures to support a safe and secure environment for students, staff, and visitors.
Name
*
First Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Affiliation with Student
*
Parent, Guardian, Custodian, etc.
Purpose or Type of Meeting/Event
*
IEP Meeting, Graduation, etc.
Reason for Attendance
*
SSD School/Building Location of Meeting or Event
Event/Meeting Location
Date of Meeting or Event (if known)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Meeting or Event Date
Time of Meeting (if known)
Picture of State Issue ID
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If permission is granted, the requester will be escorted and supervised at all times throughout the visit and will be asked to leave the school/building premises promptly after the meeting or event has concluded.
*
Yes, I understand.
Submit
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