Fentanyl Assembly Opt-Out Form

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Fentanyl Assembly Opt-Out Form

On Monday, January 30 at the Tustin Connect High School Campus MPR at 10:30 am, Sergeant Brian Gunsolley from the Orange County Sheriff's Department will be presenting information for all 7th-12th grade students on the dangers of Fentanyl within the Orange County community. The presentation will reinforce the importance of students avoiding any drug use and how to respond if they think a friend has consumed a Fentanyl pill. Students will not be asked to complete any survey or complete any forms to participate. Student participation is voluntary and there are no penalties for not participating. If parents would like to opt-out their 7th/8th grader from attending this informative 45-minute presentation, please complete the form below.

Student Name

Student Grade

7th/8th grade

9th-12th grade

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Student Advisory Teacher

Mrs. Dove

Ms. Paulson

Mrs. Bullock

Mr. David

Mrs. Desrosiers

Mrs. Fairburn

Mrs. Romberger

Mrs. Smith

Clear selection

Please confirm your preference.

Please excuse my student from the Fentanyl Presentation.

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Please type in your name below to serve as the signature.

Submit

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