Forms

Pleasantville Elementary
300 W. Columbus Street
Pleasantville, OH 43148
Phone: 740-468-2181
Fax: 740-468-3539

Pleasantville Elementary Forms

2023-2024 Free and Reduced-Price School Meals Application

As of May 31, 2022 the USDA and the US Dept. of Education, administrators of the National School Lunch Program will no longer allow school districts to provide universal Free breakfast/lunch to students without families qualifying.

For the 2023-24 school year students' families will need to complete an application to be considered for the free or reduced price meals. You may print an application or pick one up at either the District Office or any building office.

Completed applications can be turned in to your child's school or directly to the Food Service Director, Diana Browning, at the District Office. You can also email completed applications to Mrs. Browning at [email protected].

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Forms

Pleasantville Elementary Forms

2023-2024 Free and Reduced-Price School Meals Application

Kindergarten Health History Form

Immunization Exemption Form

Student Accident Insurance Plans 2023-2024

Open Enrollment Application

Dispensing Medication Form

Student Accident Insurance Plans 2021-2022