Forms & Documents

Health & Medical Forms

Please complete and return any applicable forms below to the school nurse.

Asthma (in English)

Asthma (in Spanish)

Please have your child’s doctor/nurse practitioner complete this form if your child has a history of asthma and may need to use an inhaler or other asthma medication. The form must be signed by the health care provider and by the parent/guardian. Your child can carry and take the medication independently if the appropriate boxes are checked by the provider and parent/guardian. Please return the completed form to the school nurse.

Severe Allergy

Please have your child’s doctor/nurse practitioner complete this form if your child has a history of severe allergic reactions (anaphylaxis) and may need to use an Epipen or other emergency medication. The form must be signed by the health care provider and by the parent/guardian. Your child can carry and take the medication independently if the appropriate boxes are checked by the provider and parent/guardian. Please return the completed form to the school nurse. Note: This form is only for life-threatening allergic reactions called anaphylaxis. This form is not for seasonal or environmental allergies.

HIPAA

This is a medical release form. If you agree to sign it then it gives me and your child’s health care provider permission to exchange medical information. The provider can then fax me completed medical orders, medical management plans, medical histories etc. Signing the form is voluntary. Please return the completed form to the school nurse.

Medical Management Plan

Please have your child’s health care provider fill out this form if s/he has a medical condition that the school needs more information about. Usually the school nurse will direct you to have this form completed and returned to her.

Seizure/Epilepsy

Please have your child’s doctor/nurse practitioner complete this form if your child has a history of a seizure disorder/epilepsy. The form must be signed by the health care provider and by the parent/guardian. Please return the completed form to the school nurse.

Support Programs

Tech’s nurses’s spearhead several programs to support Tech students and their families.

Tech Backpack Program for Food Insecure Bulldog Families (electronic form)

Oakland Tech has been approved for the Backpack Program through the Alameda County Food Bank for the 2018-19 school year. The Backpack Program provides identified students with a backpack of non-perishable food every two weeks. Families who enroll agree to complete client surveys for the Alameda County Food Bank. A family may enroll any time throughout the school year, and will be added to the next distribution after enrollment. If your household is experiencing food insecurity and would like to enroll, please either the electronic sign up form linked above or pick up a form in the nurses’s office in Room 110A, complete it and return it to the nurse’s office or email it to Amanda.Epperson@ousd.org.

Dual Enrollment Form

High School Dual Enrollment Form for Peralta Community College District

This form must be filled out and signed by the student, a parent or guardian, a Tech counselor and a Tech administrator. This OUSD letter explains the Dual Enrollment program.

Peer Tutoring & Senior Mentor Forms

Request for a Peer Tutor

Peer Tutors are available on a first-come, first-serve basis. Their purpose is to provide direct instructional support for students.

Request for a Senior Mentor

If you know of a 9th grader who could benefit from working with a senior mentor –– and is interested in doing so –– please give him/her the application to complete and then submit to Gynelle McBride at Gynelle.McBride@ousd.org.

Civic Center Permit Application

Facilities Civic Center Application

Oakland Unified School District allows for the use of facilities in accordance with the Civic Center act within Education Code and pursuant to Board policy. The Civic Center Act requires that each and every public school facility be made available as a civic center to members of the community and non-profit organizations for supervised and approved recreational activities, meetings and public discussion, without disruption to regular school activities. All committees and groups that plan to conduct meetings on the Oakland Tech campus MUST complete and submit the Civic Center Permit Application at least three weeks in advance. Send permit applications to Mr. Fairly, Assistant Principal, at richard.fairly@ousd.org.

PTSA Forms & Documents

PTSA Membership Form

Join the Parent Teacher Staff Association. Only $10/year for parents and caregivers and $5 for teachers, staff and students.

PTSA Grant Program Guidelines & Online Application

Reimbursement Procedures

Review these guidelines to ensure that your PTSA Check Request form is filled out correctly and contains the necessary documentation.

Check Request Form (fillable pdf)

Complete the Check Request form to be reimbursed by the PTSA for ALL approved expenses. You may forward it to treasurer@oaklandtech.com or print and place in the PTSA box in the office.

W9 Form

A W9 form must be completed and submitted to the PTSA in advance before any individual can be paid for his/her services. For the protection of the individuals’ personal information, forms may be left in an envelope in the PTSA box in the main office, addressed to PTSA Treasurer, or a password protected document may be emailed to treasurer@oaklandtech.com. The password should be sent as a separate email.

Cash Verification Form

Use this form to submit cash deposits to the PTSA. Cash must be counted and verified by two adults.

PTSA Fundraising Guidelines

Be sure to review these guidelines when seeking to raise funds for various activities and groups.

Restricted Funds Guidelines

Review the guidelines and administration of the PTSAs restricted funds.

Volunteer Hours Reporting Form

Submit hours worked each month to historian@oaklandtech.com.

PTA Toolkit

Committee Chair Manual

Forms, procedures, ideas and inspiration for getting things done at Tech, the PTSA Way!

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