Riceville Community School District

912 WOODLAND AVENUE • RICEVILLE, IOWA 50466-7507

Superintendent Office Fax 641.985.4171 • High School Fax 641.985.4001
www.riceville.k12.ia.us
Superintendent PK-12 Principal Business Manager
Barb Schwamman 641.985.2288 Vanessa Huber 641.985.2288 Jen Dunn 641.985.2288
barb.schwamman@riceville.k12.ia,us vanessa.huber@riceville.k12.ia.us jdunn@riceville.k12.ia.us

Riceville Community School Key Fob

Issued to:     _______________________    Date Issued: ___________________

I acknowledge receipt of one (1) key fob with serial number ________.

I understand that this fob is only for my use and agree that it will not be transferred to, nor allowed to be
used by, any other person.

I understand that use of this fob will result in my access to the building being tracked.

I understand that I am liable for the replacement cost of _____ if the fob is lost or damaged. I will notify
the Technology Department within 24 hours of losing the fob, or any damage to the fob which renders it
inoperable. I will not mark or deface the fob in any way.

This fob is the property of Riceville Community School District, and will be returned on the date of
resignation or at the request of Riceville Community School District administration or Technology
Department.

Recipient Signature:  __________________________            Date:_______________

Issuer Signature:  _____________________________            Date:_______________

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Date Surrendered: _________________     Reason: _______________________

Received by:    _______________________

NOTICE OF NONDISCRIMINATION
It is the policy of the Riceville Community School District not to discriminate on the basis of race, color, national origin, sex, disability, religion, creed,
age (for employment), marital status (for programs), sexual orientation, gender identity and socioeconomic status (for programs) in its educational
programs and its employment practices. There is a grievance procedure for processing complaints of discrimination. If you have questions or a grievance
related to this policy, please contact the district’s Equity Coordinator, Michelle Dohlman, School Counselor, 912 Woodland Avenue, Riceville, IA 
50466, (641) 985-2288, michelle.dohlman@riceville.k12.ia.us. For further guidance, visit the Iowa Department of Education website.