21-22 Approved Visitor Form
At this time, we are not able to host visitors on campus; when this changes, it will be required to have an approved Visitor Form on file.  Please note that you will need to fill this same form out for each person that you would like to add to the list.

Please also note: Visitors will be required to provide photo ID. If visitors will be on campus overnight, prior permission must be obtained from the Center Director, and a background check will need to be completed.

Visitor permissions may be changed at any time by contacting the school office (608-758-6110) or emailing: anna.heesen@wcbvi.k12.wi.us
Sign in to Google to save your progress. Learn more
Email *
Student Name *
Parent/Guardian *
I understand that I will need to fill out a new form for each approved visitor and that persons not listed will NOT be allowed to visit my child at WSBVI. *
If you have questions, we will follow up with a phone call.
Approved Visitor Full Name *
The following person has permission to visit my child while attending the Wisconsin Center for the Blind and Visually Impaired. I understand that these permissions may be changed at any time by submission of a new Visitor Permission form. I also understand that person(s) not listed on this form will not be allowed to visit my child.
Visitor Phone Number *
Visitor Relationship to Student *
This visitor may visit my child ON campus: *
This visitor may visit/take my child OFF campus: *
Allow this visitor to stay overnight on campus with your child? *
If visitors will be on campus overnight, prior permission must be obtained from the Center Director. Additionally, ALL overnight visitors over the age of 18 MUST pass a background check before staying on the WSBVI campus. Please contact Anna Heesen for a background check form and allow 2-3 weeks for the form to be processed/approved. Thank you!
Visitor restrictions (if any)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Wisconsin Center for the Blind and Visually Impaired. Report Abuse
Google Forms