Student Work Release Form
Submit student work and provide permission for its specified use or display.
Student Information
Student Full Name
*
First Name
Last Name
School, Course, or Grade
*
Is the student under 18?
*
Yes
No
Student Work
Work Title
*
Work Description
*
Work File
*
Upload a File
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Choose a file
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of
Permission and Signature
Intended use of the work
*
Classroom display
School publication
School website
School social media
Signer name and signature (student signs if 18 or older; parent/guardian signs if under 18)
*
Signature date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: