Student Permission to Publish on the Internet

||| Return to Publishing Student Work |||


Consent

I do hereby give _________________________________ School the right to use my:

BOX.GIF (82 bytes) first name
BOX.GIF (82 bytes) photograph
BOX.GIF (82 bytes) published project

for reproduction on the Internet. This material will only be used for activities related to the ________________________________ School's web site.

Student's Address: ______________________________________
Date: _____________________

  _______________________________
student's signature

_______________________________
student's printed name

Guardian's Consent if student is under 18 years of age

I am the parent or the legal guardian of the above-named minor and hereby approve the foregoing and consent to the use of photograph, name, and published project to the pursuant terms mentioned above.

I affirm that I have the legal right to issue such consent.

Parent's Address: ________________________________________
Date: __________________

  _______________________________
parent's signature

_______________________________
parent's printed name