2000 Lt. Governor's Writing Awards-Permission Form

Permission Form D

Name of School District___________________________________________________

Name of School_________________________________________________________

Type of Winner (class, school, district)_______________________________________

Please complete the following information for your student.

Name of Student________________________________________________

Name of Parent_________________________________________________

Family Address________________________________________________

Home Phone __________________________________________________

Name of Classroom Teacher______________________________________________________

Student Signature______________________________________________

I hereby give the School Coordinator authority to have my child’s name sent to local newspapers.

Parent Signature________________________________________________