Permission to Share Information with Other Programs 23-24 SY

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Dear Parent(s)/Guardians(s):

For the following programs, we must have your permission to share your child's name only to receive various benefits.

For more information, please contact me at scowden@fortcherry.org or 724-796-1551 Ext. 2391

Mrs. Sally Cowden
Food Service Coordinator

Email *

Parents/Guardians' Name *

Children's Name(s) & Grade(s) (list all children attending FCSD) *

I WILL ALLOW the Fort Cherry Food Service Department to share my children's name and meal eligibility status with other Fort Cherry School Programs to enable my benefits for the following programs. (Information will NOT be shared with anyone outside the School District). Check all programs you would like to participate in. *

ANGEL TREE -- This program will give assistance with clothing and gifts at Christmas time.

HELPING HANDS -- You will receive once monthly, a food box for every child in your family.

FEDERAL & STATE TESTING -- You will receive a Free/Reduced price on the fees associated with the SAT/ACT tests, etc.

COLLEGE APPLICATIONS -- You will receive discounts for fees associated with college application processes.

VO-TECH SCHOOLS – You will receive free/reduced prices pertaining to programs.

I DO NOT allow Fort Cherry Food Service Department to share my children's information with other Fort Cherry programs. I understand I will not benefit from free/reduced fees or assistance services through the Fort Cherry School District.

Required

I verify the information provided in this form has been completed by the parent listed at the top fo this form. (Type name on line as legal signature.) *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Fort Cherry School District. Report Abuse

Forms