Forms

Please complete the following forms as soon as possible.

Welcome to the 2024-2025 school year! This page contains the forms we need to start off the year.

Parents are also welcome to send in forms with their child, drop forms off at school, or scan and email forms to Mosaic ES. If you have questions about any of the information on this page, please call the office at 703-937-1600.

FormReturn Form to School?Grade Description
Emergency Care

Online, log into your SIS ParentVue account information to update weCare @ school or return paper form to school. 

The weCare @ school link is available in SIS ParentVUE on the FCPS Links button.

all

Who to contact in case parent/guardian cannot be reached. Must be updated yearly.

Must have at least 1 local Emergency Contact.

Health InformationYes, should be completed for each child at Mosaic ES and returned to school.allParents/guardians provide information on health conditions and healthcare provider.
Student Rights and Responsibilities Parent Acknowledgement Form Yes. The Acknowledgement Form should be completed for each child at Mosaic and returned to the school. Can also be completed online.allParents should review the Student Rights and Responsibilities. After review, Parent/Guardians can acknowledge receipt of the SR&R in ParentVue in your child’s SIS account or download and fill out a Parent Acknowledgement Form for each student and return to the school.
Digital Resource ConsentOnline- must be completed online for each child in FCPS.allParental consent is required for some FCPS-approved digital resources. Please review the information page and complete the online form for each child (requires SIS ParentVUE account).
Identification of Military Connected StudentsOnly return to school if you respond 'Yes' to any questions on the formallIdentify students who have a parent in the US uniformed services. Gives Virginia localities accurate data for grant funding and to receive services to meet the needs of military connected students.
Homeless Student ReferralOnly return if you respond 'Yes' to any questions on the formallIdentify homeless students in FCPS in order to provide support.
Survey, Records, Curriculum, Privacy and Related Rights and Opt-Out FormsOnly return if you do NOT want your student participating in a particular activity. allDetails on what parents/guardians can opt a child out of: Directory Information, Counseling, Information for Commercial Purposes

Family Life Education (FLE) Curriculum Description and Opt Out Information

Details on the FLE curriculum for each grade can be found at https://www.fcps.edu/academics/elementary-school-academics-k-6/elementary-family-life-education.

If you would like to opt your child out of some or all of the lessons for their grade, please complete the appropriate form below. 

Form

Return to School?

Grade 

Description

Kindergarten Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of kindergarten’s FLE lessons

Kinder

Information on opting out of FLE for kindergarten

First Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 1st grade’s FLE lessons

1st

Information on opting out of FLE for 1st grade

Second Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 2nd grade’s FLE lessons

2nd

Information on opting out of FLE for 2nd grade

Third Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 3rd grade’s FLE lessons

3rd

Information on opting out of FLE for 3rd grade

Fourth Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 4th grade’s FLE lessons

4th

Information on opting out of FLE for 4th grade

Fifth Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 5th grade’s FLE lessons

5th

Information on opting out of FLE for 5th grade

Sixth Grade Family Life Education (FLE) Opt Out

Only return if you are opting your child out of some or all of 6th grade’s FLE lessons

6th

Information on opting out of FLE for 6th grade