F 180-2 - Student Information Release Form printable pdf download

F 180-2 - Student Information Release Form

180-2

ORM

Student Information Release Form

This information is collected and distributed in accordance with the Freedom of

Information and Protection of Privacy Act, Sections 32, 33 and 37

School: _____________________________________

Date: ________________

Name of Student: _____________________________

Grade: _______________

This consent form must be signed to allow us to release student names for recognition

of achievement in academics, athletics or community involvement.

I hereby consent for _________________________ to have his/her name released for

recognition of achievement in academics, athletics or community involvement.

___________________________________

________________________________

Signature of Student if 18 Years or Older,

Signature of Parent/Legal

or Independent Student

Guardian

_______________________________

Date

For further information concerning the completion of the form, please contact your

school principal or the FOIP Coordinator at St. Thomas Aquinas Catholic Schools,

3 Alexandra Park, Leduc, Alberta T9E 4C4 986-2500.

At a minimum use for athletic teams, graduation photos

and awards announcements.

. T

RCSRD N

. 38 F

2006

HOMAS

QUINAS

ORMS

ANUAL

EPTEMBER

F 180-2 - Student Information Release Form