School Information Sharing Consent
Authorize the school to share your child's information with specified third parties.
Student's Full Name
*
First Name
Last Name
Grade/Class
*
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Specify what information can be shared
*
Academic records
Attendance records
Behavioral reports
Health information (non-medical)
Other
Purpose of Information Sharing
*
Parties with whom information may be shared (e.g., educational agencies, service providers)
*
Signature of Parent/Guardian
*
Date
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
Should be Empty: