Parent or Guardian Permission Form

Print this and have your parent or guardian sign and
fax this to 770-345-2437 or mail to address at bottom of this page

Student Information

Student name: _____________________________________________

Student address: ___________________________________________

Student address 2 __________________________________________

Student city ________________________ Student state ___________

Student country ___________ Student zip/other code _____________

Student phone _________________ Student fax __________________

Student e-mail _____________________ Student age ______

Parent or Guardian Information

Parent/ Guardian (P/G) name: __________________________________

P/G address: ___________________________________________

P/G address 2 __________________________________________

P/G city ________________________ P/G state ___________

P/G country ___________ P/G zip/other code _____________

P/G phone _________________ P/G fax __________________

P/G e-mail _____________________ 

_________________________________________________________
^{Parent or Guardian Signature (required)}

^{This must be mailed or faxed to school with Parent or Guardian signature as part of the enrollment process to:}

Click Here to return to enrollment page

© 2007 Barry Waldman