Parent / Guardian Consent Form- Six Cups Mentoring Programs
Please complete the required student information and parent/guardian consent below.
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Parent / Guardian First Name: *
Parent / Guardian Last Name: *
Student's First Name: *
Student's Last Name: *
Parent's Phone Number: *
Parent's Email:
One feature of the 6 Cups mentoring programs involve mentors and students meeting at mutually agreed upon times and public locations.  Since transportation can be an issue for some students we have provided an option for mentors to transport students if the need arises.  This would only be done if both the mentor and the student feel comfortable with this arrangement.  
If my child needs transportation to a 6 Cups meeting, I will allow my child’s mentor to transport my child:
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Parent/Guardian Consent
I agree to:

Allow my child’s school counselor and mentor to share information regarding my child’s college/career readiness.
Allow my child to meet with his / her mentor in a public place, at least 6 times for college/career planning and mentoring purposes
Allow the program to collect and maintain data pertaining to my child’s academic progress
Do you agree to the terms: *
By typing your name below, you are acknowledging that you give permission to your student to participate in the 6 Cups to College Program. *
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