Student Parent Contact Information

Student's Last Name *
Student's ID Number *
Period *
Student's e-mail address *
Parent Contact Information
Provide information so I can contact a parent or guardian in needed. You can include additional information in the next section if you want to include information for a second parent or guardian.
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/ Guardian E-mail Address *
During the course of this school year the instructor plans to show G, PG, PG-13, or R rated movies in full or as excerpts to enhance our class curriculum.

Our school requires parental permission for your son/daughter to view movies that are used in our curriculum which are rated PG, PG-13, or R.

This is a permission slip to allow your child to view all of the films/clips assigned using the teacher’s discretion in reference to curriculum correlation.

Please check one of the options *

We, the parent/guardian(s) and the student have fully read, understood, and agree to abide by the classroom rules, regulations, and expectations stated on the following documents (syllabus, AP student parent contract, integrity policy, film form) found in the school website.
My signature sustain that all the aforementioned information provided in this form is correct.
Parent Signature *
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