Forms
Please complete the following forms as soon as possible.
Welcome to the 2021-2022 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.
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Form |
Return Form to School? |
Grade |
Description |
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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. |
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Yes, should be completed for each child at Mosaic ES and returned to school. |
all |
Parents/guardians provide information on health conditions and healthcare provider. |
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Student Rights and Responsibilities Parent Acknowledgement Form |
Yes. The Acknowledgement Form should be completed for each child at Mosaic and returned to the school. |
all |
Parents 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 Consent | Online, should be completed online for each child in FCPS. | all | Parental consent is required for some FCPS-approved digital resources. Please review the information page for Mosaic ES and complete the online form for each child. |
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Only return if you respond 'Yes' to any questions on the form |
all |
Identify 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. |
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Only return if you respond 'Yes' to any questions on the form |
all |
Identify homeless students in FCPS in order to provide support. |
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Survey, Records, Curriculum, Privacy and Related Rights and Opt-Out Forms |
Only return if you do NOT want your student participating in a particular activity |
all |
Details 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.
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Form |
Return to School? |
Grade |
Description |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |
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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 |