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LTD TouchPass Request
Please enter the information requested below for your Spencer Butte Student. It is important that you complete this form for EACH of your children that attends Spencer Butte. TouchPasses will be mailed out to your family as soon as we process your request. Questions? Please email Salena Bowen @
bowen_s@4j.lane.edu
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* Indicates required question
What is your students name last name?
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Your answer
What is your students first name?
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Your answer
In the event that we need to confirm the validity of this permission, please provide your email address and text phone number that we may contact you at.
Phone Number
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Your answer
Email
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Your answer
By entering my name below, I understand that I am authorizing Spencer Butte Middle School to provide my student with an LTD TouchPass.
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Your answer
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