LCS Resiliency Survey - Opt-Out Form
If you do NOT wish to have your student participate in the Lebanon School District Resiliency Survey, please submit this form indicating your refusal to grant permission for your student to participate by January 6, 2020.
Student Name (Last Name, First Name)
Lebanon Junior High
Lebanon High School
I do not wish for my child to participate in the District Resiliency Survey
I understand that my consent shall be refused until such time as I provide written consent for my student to participate.
Submitted by: (Parent/Guardian Name)
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This form was created inside of Lebanon City Schools.