4420F - Request to
Visit School Property

TO BE COMPLETED IF YOU ARE A CONVICTED SEX OFFENDER AND ARE
REQUESTING PERMISSION TO VISIT SCHOOL PROPERTY
If you are a convicted sex offender, you must complete and submit this form in order to seek permission to visit school property whenever students are present.
If permission is granted, details of the upcoming visit(s) will be provided to the building principal. The building principal or his/her designee, who is an employee of the District, will supervise you on school property whenever you are in any student’s vicinity.
This information will be kept in the District Office as well as in the building principal’s office where you are seeking permission to visit. You must provide the date, location, and purpose for all anticipated visits to the school (e.g., drop off your child before school or pick up your child after school, attending specific activities, events, or athletic events, or during parent-teacher conferences, etc.). Please be specific in completing this form.
Datefield type date

First Name*field type single line
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Last Name*field type single line
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Email*field type email
Residence Address*field type single line
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Residence City*field type single line
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Residence State*field type single line
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Residence Zip Code*field type single line
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Will you be visiting as a parent or a service provider (e.g., delivery driver)?*field type radio button
Will you be visiting as a parent or a service provider (e.g., delivery driver)?ParentService Provider

Please list your child(ren) for whom you will be visiting District 93 schools:

If your child does not attend a District 93 school, please select "Other" from the school dropdown

	Student's Name*field type single line	School*field type drop-down	Other School - include school location*field type single line
Row 1×	Student's Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	School*field type drop-down	Other School - include school location*field type single line Input blocked. Maximum character limit of 4000 characters reached.	×

	Date*field type date	Time*field type time	Location of Visit*field type drop-down	Purpose of Visit*field type multi line
Row 1×	Date*field type date	Time*field type time	Location of Visit*field type drop-down	Purpose of Visit*field type multi line	×

Visitation Guidelines:
1. You must report to the principal’s office when visiting and log the time you enter the school on your Record of School Visits (will be provided upon approval).
2. For all other visits not listed above, you must go immediately and directly to the principal’s office to add the information on your Record of School Visits. If your requested visit will be after regular school hours, you must contact the principal’s office prior to your visit and before the end of the school day.
3. When visiting, you must remain under the direct supervision of the principal or school assigned official.
4. When you are to leave, you must go immediately and directly to the principal’s office and enter the time that you are leaving on your Record of School Visits.
5. You must then immediately leave the school property.

	Date*field type date	Time*field type time	Location of Visit*field type drop-down	Purpose of Visit*field type multi line	Recurring Visit?*field type radio button	Frequency of Visits*field type multi line
Row 1×	Date*field type date	Time*field type time	Location of Visit*field type drop-down	Purpose of Visit*field type multi line	Recurring Visit?*field type radio button Recurring Visit?YesNo	Frequency of Visits*field type multi line (e.g., 3rd Monday of every month for 3 months, Every Friday for 12 months)	×

School Yearfield type single line
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Principal Namefield type single line
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Principal Emailfield type single line
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Principal Loginfield type single line
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Superintendentfield type single line
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Superintendent Namefield type single line
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Superintendent Emailfield type single line
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Superintendent Loginfield type single line
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Schools
Schoolfield type single line
Row 1× Schoolfield type single line
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Add

	Schoolfield type single line
Row 1×	Schoolfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

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