Forms – Pulaski International School of Chicago

Complete Booklet of All Required Student Health & School Forms

Student Health and School Forms Booklet English / Folleto de Formularios Escolares y de Salud Español

Parents/Guardians, please fill out ALL of the forms found in this booklet. More information about each form can be found if you scroll down the page. Thank you!
Parent Forms to be returned for each student by the second week of school.
- CPS Emergency Form
- Student Medical Information 2020-2021 Form in English and Español
- School Fee – $75 per student
- Family Income Information Form (FIIF) (one per family)
- CPS Health Forms (immunization, updated physical, and updated dental exam)
- Media Consent Form and Release – Pulaski often uses pictures of our students on our school website, and for brochures and flyers. Please sign and return the Acceptable Usage policy so that we know if we can use your child’s picture. Please note that student names are never included in any web-based or printed materials.
- School Messaging Consent Form
- Student Code of Conduct Handbook – Sign the last page of the book and return it.
Formas se deberán entregar por cada uno de los estudiantes la segunda semana de escuela:
- Forma de Emergencia de CPS
- Student Medical Information 2020-2021 Form in English and Español
- Cuota escolar: $75 por estudiante
- Formulario Nacional de Almuerzos Escolares IFIIF) (una para la familia)
- Formularios de salud de CPS (vacunación, examen físico y dental actualizado)
- Consentimiento de prensa y dispensa de responsabilidad – A menudo usamos imágenes de nuestros estudiantes en nuestros materiales de publicidad, tales como folletos, volantes o el sitio web de la escuela. Por favor firme y entréguelo para que sepamos si podemos utilizar la imagen de su hijo (a). Tenga en cuenta que los nombres de los estudiantes no se incluyen en los materiales de marketing.
- Formulario de consentimiento para mensajes de la escuela
- Manual del Código de Conducta del Estudiante – firmar y devolver la última página del libro.
CPS Enrollment Forms, Resources, & FAQs webpage
Complete Booklet of All Required Student Health and School Forms

Student Health and School Forms Booklet English / Folleto de Formularios Escolares y de Salud Español

All parents and guardians are required to submit the following forms to their school clerk as soon as possible.
- Student Medical Information 2020-2021 (page 5)
- Request for Emergency and Health Information (page 25)
- School Messaging Consent Form (page 27)
- Media Consent Form and Release (page 29)
- Family Income Information Forms (page 31)
Se les requiere a todos los padres y tutores que entreguen los siguientes formularios a la oficinista de su escuela lo antes posible.
- Información médica del estudiante 2020-2021 (Student Medical Information 2020-2021) – página 5
- Solicitud de información de emergencia y salud (Request for Emergency and Health Information) – página 25
- Formulario de consentimiento para recibir mensajes escolares (School Messaging Consent Form) – página 27
- Formulario de consentimiento de prensa y divulgación de información (Media Consent Form and Release) – página 29
- Formularios de información de ingreso familiar (Family Income Information Forms) – página 31
Health Requirements

A letter from the Pulaski Nurse about health requirement deadlines
Chronic Disease Forms

CPS Office of Student Health and Wellness Chronic Disease Information and Forms / Proceso de verificacion de enfermedades cronicas anual de CPS
School Messaging Consent Form

Your school and the district will periodically want to send information regarding school or district events,
updates or initiatives. We will utilize the phone messaging system to remind you about these events, updates,
and initiatives; including report card distribution, field trips, community events, parent-teacher conferences,
announcements, COVID 19 information and screenings, and more. To ensure you receive periodic
school or district related notifications and reminders, your consent is needed below.

**Please fill out and return this form to ensure you receive informational calls and texts**

Student media consent form: English | Spanish

Media Consent Form

In order for your child to be photographed, filmed or videotaped for non-profit use by CPS, he or she must have a consent form signed by a parent or guardian on file at school. Consent forms are generally handed out during the first week of school. Consent forms for both students are available for download below. Return the signed form to your child’s school.

Student media consent form: English | Spanish

Family Income Information Form (FIIF)

Family-Income-Information-Form in English and Español

The Community Eligibility Provision (CEP) of the Healthy, HungerFree Kids Act of 2010 allows CPS to offer free breakfast and lunch to all students. As such, Free and Reduced Meal (FRM) applications will not be collected from parent/guardians of CPS students. All schools will now collect the Family Income Information Form (FIIF) in order to determine the appropriate allocation of the Title I, SGSA and ERate funds, as well as student eligibility to waive other fees such as book, testing fees, school fees, etc. It is imperative that every Pulaski student submits a Family Income Information Form every school year.

Formulario de información de ingresos familiares (FIIF)

La Disposición de Elegibilidad Comunitaria (CEP) de la Ley de Niños Sanos y Libres de Hambre de 2010 permite que CPS ofrezca desayuno y almuerzo gratis a todos los estudiantes. Como tal, las solicitudes de comida gratis y reducida (FRM) no se recopilaran de los padres / tutores de los estudiantes de CPS. Todas las escuelas ahora recopilaran el Formulario de información de ingresos familiares (FIIF) para determinar la asignación adecuada de los fondos del Título I, SGSA y E-Rate, así como la elegibilidad de los estudiantes para obtener sin cargos libros, cuotas de exámenes, cuotas escolares, etc. Es imperativo que cada estudiante de Pulaski presente un Formulario de información de ingresos familiares cada año escolar.

School Fee- $75

In order to offset costs, each student is expected to pay a school fee of $75, which will be collected from students at the start of the school year. The fee will be used to purchase an agenda book for 2nd– 8th grades, all students K-8 will get a Pulaski t-shirt, instructional materials, including classroom workbooks and Scholastic magazines; and technology repairs, support with school field trips for students in need.

Click Here for IL e-Pay to pay student fee online

Please send your child’s student fee to his/her teacher by September 13. If circumstances do not allow you to meet this deadline, please make special arrangements at the Main office. To qualify for the fee waiver, the Family Income Information Form (FIIF – see below) must be completed and returned to the school. For those who qualify, the CPS Fee Waiver Form (https://clerks.cps.edu/Finance/Forms/School_Fee_Waiver_Form.pdf) may be filled out and returned to the school.

Family Income Information Form (FIIF) – The Community Eligibility Provision (CEP) of the Healthy, HungerFree Kids Act of 2010 allows CPS to offer free breakfast and lunch to all students. As such, Free and Reduced Meal (FRM) applications will not be collected from parent/guardians of CPS students. All schools will now collect the Family Income Information Form (FIIF) in order to determine the appropriate allocation of the Title I, SGSA and ERate funds, as well as student eligibility to waive other fees such as book, testing fees, school fees, etc. It is imperative that every Pulaski student submits a Family Income Information Form every school year.