ACCESS TO SCHOOL PROPERTY BY SEX OFFENDERS
This form is to be completed each time access is requested and is limited to that specific occurrence unless otherwise noted below, and must be submitted three (3) school days in advance to the applicable building Principal or Superintendent.
Name___________________________________ Date of Request________________________
Date of Birth (Month/Day/Year)________________ Gender (circle one) Male Female
Home Address _________________________________________________________________
Home Cell Work
E-mail address ________________________________________________________
Date(s) Requesting to be on School Property_____________________________________________
Time of Day Requesting to be on School Property_________________________________________
Name of School/Building or Location on School Campus________________________________
Access shall be limited to the building and/or location noted herein, the parking lot and sidewalk/public access to the building or location designated herein.
State the specific reason/nature of the request to come upon school property_______________
* * * * *
If request is related to your employment, provide the following information:
Current Employer __________________________________________________________________
Years Employed ___________ Name of Immediate Supervisor _________________________
Supervisor’s Phone Numbers _________________________________________________________
Applicant may NOT come on school property until applicant has received this form indicating approved by the Superintendent and access shall be limited as indicated below.
Signature below indicates the information provided herein is true and accurate and requesting party is in full compliance with all Wyoming statutes regarding registered sex offenders.
**SCHOOL USE ONLY**
Form Submitted to:
Principal/Superintendent Name____________________________ Building________________
Date Form Received ____________________________________
Limitations/Expectations for Access_________________________________________________
This request is ___ Approved ____ Denied
Superintendent Signature Date