7:340-E3 Parent Permission Form

Please indicate acknowledgement for each item and, where applicable, for which you grant or do not grant permission.

YES/NO Student Handbook, Code of Conduct and Technology Use Policy

The Student Handbook, Code of Conduct, and Technology Use Policy are updated yearly and are available on my child’s school website.

I understand that it is my responsibility to review and discuss the Student Handbook and related documents with my child.

 YES/NO  Student Request for Use of Textbooks

The State of Illinois funds a textbook program to supply textbooks for student use.  Some of the textbooks currently used by the District have been purchased through this program.  It is a requirement of the State that the District receive permission to loan these textbooks to students.

I hereby request the loan of these secular textbooks in accordance with public Act 79-961 of 1975.

 YES/NO Alcohol-based Hand Sanitizer

According to the Centers for Disease Control, the use of the hand sanitizer is an effective and safe component of good hand hygiene practices and helps stop the spread of germs that can make your student and others sick.

I give permission for my student to use alcohol-based hand sanitizer.

 YES/NO Asbestos Management Plan

All District facilities have been inspected for asbestos containing materials.  We provide all the information for dealing with asbestos to parents, students and staff as recommended by the Environmental Protection Agency and the Illinois Department of Public Health.  Information concerning our Asbestos Management Plan is available at www.bps101.net

I understand that the Asbestos Management Plan and inspection reports are available online or by contacting the District Office.

 YES/NO Integrated Pest Management Registry

The District practices an Integrated Pest Management program that combines preventative techniques, non-chemical pest control methods, and the appropriate use of pesticides with a preference for products that are the least harmful to human health and the environment.  The Integrated Pest Management Registry notifies registrants when pesticides are applied on school grounds.

I wish to be included in the Integrated Pest Management Registry.

 YES/NO Permission to Use Biometric Information

Biometric identification is the use of automated methods to recognize a student based upon  a physiological or behavioral characteristic.  Student biometric information (finger scan) is used solely for identification or fraud prevention (i.e., lunch sales).  All biometric information is automatically deleted after 120 days of account inactivity.

I consent to the use of biometric information (finger scan) for my student.

 YES/NO Information Release for School Media and Publications

The District uses student information in publications such as honor rolls, press releases, yearbooks, and other school-related purposes.  Student information, also known as student directory information, includes name, address, gender, grade level, parent(s’) names, addresses, email addresses, telephone numbers, and photographs.

I consent to the use of my student’s name and photo in school publications (electronic and print), including the honor roll, yearbook, etc.

 YES/NO Information Release for Student Directories and School Partnership Organizations

Schools may publish a student and parent directly to facilitate communication.  Additionally, the District shares parent and student contact information with recognized partner organizations (e.g. PTO’s, Music Buffs, STAGE, athletic boosters) to support and enhance student’s educational experiences.

I wish that my contact information and my student’s information be shared in school directories and with official, District-recognized organizational partners.

 YES/NO Information Release to Military Recruiters

I request that the name, address, and telephone listing or any other information about my child be released to military recruiters only with my prior written consent.

 YES/NO Revocation of Permissions

The permission and requests provided herein are valid until they are changed, revoked, or the above-named student becomes 18.

I understand that these permissions will remain valid as long as my student is enrolled in the District and that I may, at any time, revoke any or all of these permissions by notifying the Principal in writing.

Date Approved: May 29, 2009

Date Amended:  May 24, 2016