MIS Forms for Pasco County Schools - For Internal Use Only

Asst. Supt.

• MIS 102   Cell Phone Stipend Request - Request to receive a cell phone stipend for employees (Revised 1/22)
• MIS 105   Information Card - Provide school front office and teachers with information (Revised 4/17)
• MIS 105 Sp.   Information Card - Provide school front office and teachers with information (Revised 4/17)

Communications

• MIS 621 Sp.   School Volunteer Application - School Volunteer Application (Revised 9/15)
• MIS 661   Peer Volunteer Application - To be completed by peer volunteer applicants (Revised 5/24)
• MIS 667   Release Form for Publication of Student Information - "To authorize use of voice, picture, etc." (Revised 5/12)
• MIS 667 Sp.   Release Form for Publication of Student Information - "To authorize use of voice, picture, etc." (Revised 5/12)

CTE

• MIS 603   Cooperative Education Training Agreement - District requirements for co-op programs (Revised 8/09)
• MIS 615   Co-Enrolled Adult Education Class Registration Form - To obtain co-enrolled student registration data (Revised 8/19)
• MIS 619   Career and Technical Education Class Registration Form - To obtain adult vocational student registration data (Revised 3/08)
• MIS 628   Cooperative Education Student Agreement - Student agreement to be in Cooperative Education (Revised 8/09)
• MIS 655   Fee Supported/Community Ed Registration/Receipt - Documentation (Revised 11/08)

EBARM

• MIS 360   "Instructional, NI & Admin. Leave Bank - With. Ap." - Application for withdrawal (Revised 5/18)
• MIS 406   Report of Student Injury/Accident - Student involved in accident (Revised 9/15)
• MIS 406A   Investigation of Student Injury/Accident Report - Student involved in accident (Revised 9/15)

Finance

• MIS 106   Field Trip Request Form - Used to request approval for field trip (Revised 6/15)
• MIS 112   Professional Development Travel Request - Request for travel and expenses reimbursement for professional development activities (Revised 2/25)
• MIS 115   Budget Amendment Request - To amend cost center budget (Revised 4/19)
• MIS 120   Journal Entry - To enter journal payments (Revised 01/25)
• MIS 129   Interdepartmental Request - Type A - To order materials from internal sources (Revised 4/15)
• MIS 153A   Change Fund Log - To record change fund (Revised 2/17)
• MIS 153B   Change Fund Sub Log - To record change fund for specific activity (Revised 2/17)
• MIS 155   Field Trip Chaperone List - To record chaperones participating with field trips (Revised 4/19)
• MIS 156A   Gift Card/Certificate Purchase Log - To record the purchase of gift cards or certificates (Revised 4/24)
• MIS 156B   Gift Card/Certificate Distribution Log - To record the distribution of gift cards or certificates (Revised 4/24)
• MIS 158   Sales Tax Paxment Request - To remit sales tax payment to the District (Revised 4/24)
• MIS 159A   Ticket Inventory - To track numbered ticket inventory (Revised 5/17)
• MIS 159B   Ticket Distribution Sub Log - To track numbered ticket inventory for specific activity (Revised 5/17)
• MIS 160   Year End Ticket/Wristband Inventory - Record of ticket/wristband inventory at school (Revised 9/24)
• MIS 161   Year End Inventory - "Record of concession, textbook or school store inventories" (Revised 9/24)
• MIS 169   Report of General Sales - Record monies at school (Revised 10/24)
• MIS 170   Report of Monies Collected Internal/Student Activities Accounts - To record monies collected from students (Revised 4/18)
• MIS 171   Report of Tickets Sold Internal/Student Activities Accounts - To support collections from the sale of admission tickets (Revised 3/18)
• MIS 172   Purchase Request - To document internal accounts purchases (Revised 7/19)
• MIS 173   Compensation Report - To document payments to personnel for services performed. (Revised 10/24)
• MIS 173A   Athletic Event Payment Request - To document payments to personnel for services performed. (Revised 02/25)
• MIS 176   Fund Raising Activity (FRA) Application/Recap - Fund Raising Application (Revised 10/19)
• MIS 177A   Parking Agreement - Parking Agreement form (Revised 11/23)
• MIS 177B   Concession Stand Agreement - Concession Stand Agreement form (Revised 11/23)
• MIS 179   Athletic Participation Monies Collected Internal/Student Activities Accounts - To account for try out and athletic participation fees collected by secondary coaches and ADs (Revised 3/18)
• MIS 209   Capitalized Property Transfer Form - To transfer tagged assets from one cost center to another (Revised 7/24)
• MIS 210   Capitalized Property Disposal Form - To transfer non-technology tagged assets. Procedures to dispose of tagged technology assets are located in the Property Control Procedures (Revised 01/25)
• MIS 215   Petty Cash Reimbursement Request - Reimbursement for petty cash expenditures (Revised 3/96)
• MIS 216   Request for Payment - Used to request payment (Revised 9/18)
• MIS 221-23   Bi-weekly Time Sheet - To document time worked by district employees (Revised 7/14)
• MIS 522   Trainer Pay for Instructional/SRP - To document trainer hours for payment of services. (Revised 5/14)
• MIS 524   Employee Stipend Payment - To certify and authorize payment of Inservice Participants (Revised 5/19)
• MIS 526   Request for Payment for Services Rendered - Certify and authorize payment for con. and tech. services (Revised 7/03)

FNS

• MIS 151   SFS Invoice - To bill outside organizations for food service (Revised 3/25)

HREQ

• MIS 101   Leave or Temporary Duty Request - Request for leave or temp. duty for employees (Revised 1/18)
• MIS 162   New Hire FRS Certification Form - Required as part of the new hire process (Revised 7/14)
• MIS 300   Name Change request - Update D.O. information for changes to employees data. (Revised 8/22)
• MIS 302   Employment Agreement Probationary Period - Probationary paperwork for all new hires (Revised 4/16)
• MIS 303   Personnel Action Form - "Resignation, termination, retirement, promotion or transfer" (Revised 7/21)
• MIS 304   Personal Information Form - Provides employee data. (Revised 12/16)
• MIS 306   Request for Family & Medical Leave - Application to apply for family and medical leave (FMLA). (Revised 5/18)
• MIS 307   Certification of Physician or Practitioner - Required to apply for specific types of leave under FMLA. (Revised 2/18)
• MIS 307d   Certification of Physician or Practitioner - Required to apply for specific types of leave under FMLA. (Revised 2/18)
• MIS 309   Employee Sick Leave Transfer Request - Employee request to transfer accrued sick leave to Family (Revised 2/02)
• MIS 310   Telephone Reference Check - To document reference check before employment is offered (Revised 2/15)
• MIS 321   Noninstructional Non-Exempt Evaluation - Assess job performance/non-instruc. employee (Revised 2/15)
• MIS 342   O/PT Assistant Evaluation - Assess job performance (Revised 2/15)
• MIS 353   Bus Driver Evaluation - Assess job performance/Bus Driver (Revised 2/15)
• MIS 362   Voluntary Employee Sick Leave Donation Application - To request voluntary donation of sick leave to another employee (Revised 9/15)
• MIS 364   Voluntary Employee Sick Leave Donor Form - To request voluntary donation of sick leave to another employee (Revised 9/15)
• MIS 366   Noninstructional Exempt-Level Evaluation Form - Annual Assessment (Revised 8/22)
• MIS 372   Administrative Salary Adjustment - Change salary status of administrators (Revised 1/07)
• MIS 373   General Competency Req. / Teacher Cert. Statement - Statement of understanding for teacher cert. (Revised 12/07)
• MIS 545   Position Control Change Form - Allocation Change (Revised 1/18)
• MIS 584   ESOL Condition of Employment - Informs teachers who serve LEP students of rules & requirements. (Revised 4/14)

OLL

• MIS 557   Curriculum Project Development Agmt. - Data to pay participants of cur. dev. projects (Revised 8/22)
• MIS 558   Internal Contract for Assessing and/or Leadership Mentoring - Data to pay participants for mentoring (Revised 11/20)

OSSPS

• MIS 140    Student Residency Questionnaire / Domicile - SIT Program (Revised 4/24)
• MIS 140 Sp.    Student Residency Questionnaire / Domicile - Questionnaire for additional educational services (Revised 6/20)
• MIS 141   Affidavit of Residency - Used by parents and/or legal guardians when registering students (Revised 8/24)
• MIS 141 Sp.   Affidavit of Residency - Used by parents and/or legal guardians when registering students (Revised 8/24)
• MIS 142   Migrant Questionnaire - This form is included in the registration packets that parents and/or guardians fill out (Revised 3/21)
• MIS 142 Sp.   Migrant Questionnaire - This form is included in the registration packets that parents and/or guardians fill out (Revised 3/21)
• MIS 206   Non-Student SESIR Event Report - Incident documentation (Revised 4/17)
• MIS 400a.docx   Conference Notes - RIGHT CLICK TO DOWNLOAD-For documentation of parent conferences. (Revised 3/25)
• MIS 400b   PMP Conference Notes - For documentation of parent PMP conferences. (Revised 3/25)
• MIS 405   Student Record Access Log - Record of request for information from student records. (Revised 3/03)
• MIS 411   School Documentation of Physical Restraint and/or Secured Seclusion - School documentation of physical restraint and/or secured seclusion (Revised 7/12)
• MIS 412   Parent Notification of Physical Restraint and/or Secured Seclusion - Parent notification requirements related to physical restraint (Revised 7/12)
• MIS 415   Grades 6-12 Emergency Information - To record family data on students for emergencies (Revised 4/17)
• MIS 415 Sp.   Grades 6-12 Emergency Information - To record family data on students for emergencies (Revised 4/17)
• MIS 416   Grades PreK - 5 Emergency Information - To record family data on students for emergencies (Revised 4/17)
• MIS 416 Sp.   Grades PreK - 5 Emergency Information (Spanish Version) - To record family data on students for emergencies (Revised 4/17)
• MIS 420   Consent for SS Assistance - Used to obtain permission for services (Revised 1/11)
• MIS 420 Sp.   Consent for SS Assistance (Spanish Version) - Used to obtain permission for services (Revised 3/20)
• MIS 447   Transfer Student 30 Day Immunization Waiver - This form is used by students registering that need an extended period of time to have updated Florida immunization records (Revised 4/14)
• MIS 452   Psych. Reports Review - Certify reports from other districts (Revised 5/13)
• MIS 538   Grants Summary and Signature Sheet - Record summary data on grant proposals (Revised 4/25)
• MIS 538instructions   Instructions for Grants Summary and Signature Sheet - Record summary data on grant proposals form (Revised 4/25)
• MIS 538B   MIS 538 Budget Form - Record budget data on grant proposals (Revised 5/23)
• MIS 582   ESOL Program Eligibility Determination - Notification to parents of program eligibility of their child in the ESOL (Revised 10/12)
• MIS 582 Sp.   ESOL Program Eligibility Determination - Notification to parents of program eligibility of their child in the ESOL (Revised 10/12)
• MIS 583   ESOL Notification of Program Ineligibility - Notification of ineligibility to receive ESOL services (Revised 10/12)
• MIS 585   ELL Committee Meeting Minutes - ELL Committee Meeting notes. (Revised 9/19)
• MIS 587   Invitation to Attend ELL Committee Meeting - ESOL Invite to meeting (Revised 9/19)
• MIS 587 Sp.   Invitation to Attend ELL Committee Meeting - ESOL Invite to meeting (Revised 9/19)
• MIS 587 Ar.   Invitation to Attend ELL Committee Meeting - ESOL Invite to meeting (Revised 9/19)
• MIS 587 Ve.   Invitation to Attend ELL Committee Meeting - ESOL Invite to meeting (Revised 9/19)
• MIS 588   ESOL Exit Determination - Notification to parent that child has been determined to no longer require ESOL Program Services (Revised 10/12)
• MIS 588   Notification of Eng. Language Proficiency and Continuation of Services - "Notify parents of ESOL program eligibility, continuation or exit" (Revised 10/12)
• MIS 588 Sp.   ESOL Exit Determination - Notification to parent that child has been determined to no longer require ESOL Program Services (Revised 10/12)
• MIS 588 Sp.   Notification of Eng. Language Proficiency and Continuation of Services - "Notify parents of ESOL program eligibility, continuation or exit" (Revised 10/12)
• MIS 630   Guidelines for Home Education Student Enrolled as Part-Time Student - Document parent/guardian agreement related to home school students who wish to attend zoned secondary school on a part-time basis. (Revised 3/22)
• MIS 704   "ESE Mutual Agreement to Extend 60 Day Timeline, Initial Evaluation, SLD" - Meet State & Federal regulations pertaining to Special Education (Revised 12/14)
• MIS 705   "ESE Mutual Agreement to Extend 20 Day Timeline, Consent to Evaluation" - Meet State & Federal regulations pertaining to Special Education (Revised 12/14)
• MIS 718    Exceptional Student Education Reevaluation Report - Reevaluation data (Revised 2/18)
• MIS 718 Sp.   Exceptional Student Education Reevaluation Report - Reevaluation data (Revised 2/18)
• MIS 722   ESE After School IEP Conference Reimbursement Form - Information required to process reimbursements for conferences (Revised 1/24)
• MIS 723   ESE After School IEP/TIEP Development Reimbursement Form for After Hours - Information required to process reimbursements for payment (Revised 1/24)
• MIS 730   ESE Speech and Language Evaluation Report - To record speech and language evaluation (Revised 6/04)
• MIS 730 Sp.   ESE Speech and Language Evaluation Report - To record speech and language evaluation (Revised 6/04)
• MIS 731   ESE Audiology Referral - Individual student audiology referral (Revised 5/14)
• MIS 731 Sp.   ESE Audiology Referral - Individual student audiology referral (Revised 7/01)
• MIS 732   ESE Physical/Occupational Therapy Prescription - To report diagnosis and treatment (Revised 7/13)
• MIS 732 Sp.   ESE Physical/Occupational Therapy Prescription - To report diagnosis and treatment (Revised 7/13)
• MIS 733   ESE Speech and Language Reevaluation Report - To record speech and language reevaluation (Revised 1/05)
• MIS 733 Sp.   ESE Speech and Language Reevaluation Report - To record speech and language reevaluation (Revised 1/05)
• MIS 780   Hospital/Homebound and Off-Campus Instruction Time Sheet - Biweekly sheet for homebound/off-campus students (Revised 10/17)
• MIS 789   ESE Speech/Language/Hearing Screening Report - "Screening applications for speech, language and hearing" (Revised 4/19)
• MIS 790   FERPA Release of Student Information/Records - Authorizes release of student information (Revised 4/24)
• MIS 791   Release of Records - Permission - Request for release of student info. (Revised 2/24)
• MIS 791 Sp.   Release of Records - Permission - Request for release of student info. (Revised 2/24)
• MIS 818   ESE Physical Examination - Sent to physician for physical examination for Physically Impaired Program (Revised 7/23)

OSSPS (Safety Officer)

• MIS 104   Emergency Drill Record - Record and verify completion of emergency drills at school facilities (Revised 1/10)

OTIS

• MIS 100   Forms Mgt. & Control Application / Authorization - "Used for forms control, submit completed form to Information Services." (Revised 1/94)
• MIS 148   Student Registration Form - Register student for data entry (Revised 4/17)
• MIS 148 Sp.   Student Registration Form (Spanish Version) - Register student for data entry (Revised 4/17)
• MIS 150   Security Authorization Form - Security Access to AS400 - District Office (Revised 4/09)
• MIS 180   Telecommunications Inventory Removal/Return Form - Inventory Control (Revised 4/00)
• MIS 189   Cellular Telephone Use Guidelines - School Board Policy (Revised 3/07)
• MIS 190   Electronic Network Use Guidelines for Employees - School Board Policy (Revised 12/17)
• MIS 191   Electronic Network Use Guidelines for Students - School Board Policy (Revised 2/16)
• MIS 191 Sp.   Electronic Network Use Guidelines for Students - School Board Policy (Revised 2/16)
• MIS 192   Equipment Checkout Guidelines for Employees - Inventory checkout (Revised 3/20)
• MIS 193   Equipment Checkout Guidelines for Students - Inventory checkout (Revised 4/20)
• MIS 193   Equipment Checkout Guidelines for Students - Inventory checkout (Revised Sp. 9/23)
• MIS 547   Request to Dispose of Scheduled Records - To dispose of dept./school records (Revised 2/17)

OTL

• MIS 166   Parent Release - Parental permission for student to attend field trip. (Revised 2/23)
• MIS 166 Sp.   Parent Release - Parental permission for student to attend field trip. (Revised 2/23)
• MIS 166A   Parent Release - Parental permission for student to attend field trip. (Revised 2/23)
• MIS 166A Sp.   Parent Release - Parental permission for student to attend field trip. (Revised 2/23)
• MIS 166E   District-School Sponsored Activity - Parental permission for District-School Sponsored Activity. (Revised 10/23)
• MIS 166E Sp.   District-School Sponsored Activity - Parental permission for District-School Sponsored Activity. (Revised 10/23)
• MIS 437   Progress Monitoring Plan (PMP) Change in Status Information - Advise parents of changes in the AIP status (Revised 3/08)
• MIS 437 Sp.   Progress Monitoring Plan (PMP) Change in Status Information - Advise parents of changes in the AIP status (Revised 3/08)
• MIS 438   Student Academic Progress K12 - New to Pasco - Information letter for new parents (Revised 2/20)
• MIS 438 Sp.   Student Academic Progress K12 - New to Pasco - Information letter for new parents (Revised 3/08)
• MIS 453   High School Report Card Back - High school grade legend/requirements (Revised 8/17)
• MIS 453 Sp.   High School Report Card - To report high school student's grades (Revised 9/17)
• MIS 454   Middle School Report Card - To report middle school student's grades (Revised 4/14)
• MIS 454 Sp.   Middle School Report Card - To report middle school student's grades (Revised )
• MIS 460   Secondary Student Progress Report - To report secondary school progress (Revised 4/14)
• MIS 460 Sp.   Secondary Student Progress Report - To report secondary school progress (Revised 8/08)
• MIS 590   Primary Report Form K-2 - Reporting student progress (Revised 11/15)
• MIS 590 Sp.   Primary Report Form K-2 - Reporting student progress (Revised 11/15)
• MIS 591   Primary Mid-Quarter Progress Report - Reporting student progress (Revised 7/10)
• MIS 591 Sp.   Primary Mid-Quarter Progress Report - Reporting student progress (Revised 10/10)
• MIS 592   Intermediate Report Form 3-5 - Reporting student progress (Revised 11/15)
• MIS 592 Sp.   Intermediate Report Form 3-5 - Reporting student progress (Revised 11/15)
• MIS 593   Intermediate Mid-Quarter Progress Report - Reporting student progress (Revised 7/10)
• MIS 593 Sp.   Intermediate Mid-Quarter Progress Report - Reporting student progress (Revised 10/10)
• MIS 594   Narrative Report Form (All K & Emergent Learner) - Reporting student progress (Revised 9/08)

OTL-Media

• MIS 613   Reconsideration of Materials - Used by parents and/or staff in regards to fiction and other literary materials (Revised 5/17)
• MIS 613 Sp.   Reconsideration of Materials - Used by parents and/or staff in regards to fiction and other literary materials (Revised 5/17)
• MIS 614   Reconsideration of Materials - Used by parents and/or staff in regards to nonfiction materials (Revised 5/17)
• MIS 614 Sp.   Reconsideration of Materials - Used by parents and/or staff in regards to nonfiction materials (Revised 5/17)
• MIS 617   Review of Ins. Materials Request - Questionnaire completed regarding review of materials (Revised 12/16)
• MIS 617A   Checklist - Media Committee's Reconsideration - Fiction & Other Literary Forms - "Assist in book review to determine appropriate purpose, theme or message conveyed by the book." (Revised 1/03)
• MIS 617B   Checklist - Media Committee's Reconsideration - Notification - "Assist in book review to determine appropriate purpose, theme or message conveyed by the book." (Revised 1/03)
• MIS 642   Dual Enrollment Textbook Depository Voucher - Used by dual enrollment students for required textbooks (Revised 1/18)

Purchasing

• MIS 149   Complaint Report - To record complaints against vendor/products (Revised 7/90)
• MIS 218   Professional/Technical Serv. Contract - For services unavailable from Sch.Brd. employees (Revised 8/18)

Sponsor

• MIS 421   Work Waiver Application for Waiver of Child Labor Law for Minors (under 18 years of age) enrolled in Pasco Count Public Schools - OSSPS (Revised 9/24)
• MIS 792   FERPA Amendment to Records Request. - OSSPS (Revised 6/24)
• MIS 792 Sp.   FERPA Amendment to Records Request-Spanish - OSSPS (Revised 4/24)

Transportation

• MIS 167   Private Vehicle Insurance Information - Insurance info. for vehicles transporting students (Revised 2/23)
• MIS 167 Sp.   Private Vehicle Insurance Information - Insurance info. for vehicles transporting students (Revised 2/23)

Warehouse

• MIS 131   Monthly Vehicle Usage Log - To record vehicle usage (Revised 11/93)

7/12/25 2:30:04 AM