School Security Policy Acknowledgment Form
Please review and acknowledge your understanding of the school security policy. Completion of this form is required for all relevant staff, students, and visitors.
Full Name
*
First Name
Last Name
Role/Relationship to School
*
Please Select
Staff
Teacher
Student
Parent/Guardian
Contractor/Vendor
Visitor
Other
School Name
*
Department or Grade
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Have you thoroughly read and understood the School Security Policy?
*
Yes, I have read and understood the policy.
No, I need more information.
Please share any questions or comments regarding the security policy (optional)
Submit Acknowledgment
Should be Empty: