Gouverneur
Forms Library
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Community Eligibility Provision / Household Income Eligibility 21-22
We ask you fill out this form even though breakfast and lunch are free to all students to help provide further funding for our district, such as Title 1, backpack program, and SUPA.
- Authorization for Administration of Medication
- Authorization for Release of Health Records from the District
- Authorization for Release of Health Records from the Doctor
- BMI Screening Participation / Opt Out
- Emergency Contact Sheet
- OTC Permission Slip
- Physical Form
- Student Health Data Sheet (new students only)