Web Permission Slip for Students

Student Name_________________________________________________________________________________

School________________________________________

Grade_____________

Dear Parent/Guardian:

As the parent or legal guardian of the above named student, your permission is requested to have your child's work and/or photographs on the Milford Public School web site.

Check one:

I grant permission to have my child's student work published on the school web site.
I do not grant permission to have my child's student work published on the school web site.

Check one:

I grant permission to have my child's photograph published on the school web site.
I do not grant permission to have my child's photograph published on the school web site.

Check one:

I grant permission for my child's first name only to be on the school web site.
I do not want my child's name on the web site.

Print Name_______________________________________________________________

Relationship_______________________________________________________________

Signature_______________________________________________________________

Date________________________

revised 2/29/00