Educational Services Center
1921 A Street La Porte, Indiana 46350
Phone: 219-362-7056 Fax: 219-324-9347

Online Forms and Documents

Most forms are provided in PDF format. If you are unable to view any of these documents, please download Adobe Reader for free at www.adobe.com.

Form Name Description
Child Protective Services Report  
CHIRP Form Permission form to release information to the Children and Hoosiers Immunization Registry Program (CHIRP)
Level 1 Complaint Form
Level 2 Complaint Form
Level 3 Complaint Form
Level 4 Complaint Form

These forms are to be used to document complaints by individuals regarding student matters, personnel, or policy violations.
Consent for Administration of Medication Parent's consent for to allow the school to administer medicine if necessary
Dental Examination Form Print and take with you to your dentist for completion
Elementary Enrollment Form Complete, print and submit to the school your child will be attending
Formal Report of Harassment and or Intimidation  
Immunization Form Immunization form and requirements for students
Informal Report of Harassment and or Intimidation  
Preliminary Report of Alleged Child Abuse or Neglect State Form 114  
Report of Bullying Allegations  
School Health Insurance Enrollment Form Covering Kids & Families free and low cost health insurance enrollment
Student Health Record and Examination Form Print and take with you to your child's doctor for completion
Student Illness Criteria Criteria that is considered before a student is considered too ill to attend class
Unwanted Behavior Complaint Form The goal of this complaint procedure is to stop inappropriate behavior and to investigate and facilitate a resolution to the problem.
Volunteer Criminal History Form