LCS Resiliency Survey - Opt-Out Form
Dear Parent/Guardian(s):

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) *
Your answer
Student ID *
Your answer
Building *
Grade level *
Consent Refusal *
Submitted by: (Parent/Guardian Name) *
Your answer
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