Forms Authorization Request Template

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FORMS AUTHORIZATION REQUEST
Form Title: _______________________________________________ Request Date: _______________
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Form Type:
New
Revised (see box below)
Obsolete
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Languages:
English
Spanish
Haitian-Creole
Function of Form:
If revising a form, please attach the existing form with clearly marked revisions.
Does the form impose requirements or solicit any information not required by Statute or by an
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existing rule?
Yes
No
Form’s Targeted Audience:
(Check all that apply.)
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All Employees
District Administrators
School Administrators
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Instructional
Non-Instructional
Students
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Parents
Other Persons
Do you authorize Records & Forms Management to make this form available via our website?
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Yes
No
Work Location Name/Number: _____________________________________________________________
Form Initiator: _____________________________________ Contact Number: _____________________
Administrator’s Name/Title: _______________________________________________________________
Administrator’s Authorizing Signature: ________________________________
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FOR OFFICE USE ONLY
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Board Approval:
Yes
No
Signature ___________________________________________
FM-1229 Rev. (02-17)

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