Parent/Guardian Form for
Including Student Likeness/Name/Work on School Internet Web Sites

Web Pages requires parent/guardian and student permission for any of the following to be published on web Pages:
- Unique student-generated work
- Recognizable student likeness or photograph
- Full first and last name of student
Without the permission slip signed and on-file, only student's first name and last initial may be
used on Web Pages. If a student is 18 years of age or older, the parent/guardian permission is not


Web Page Permission Form

Student Name__________________________________

I hereby understand and agree that the following information indicated may be included in web Pages

Check yes or no for each of the following permissions

Yes________ No_______ Student's recognizable likeness or photograph
Yes________ No_______ Unique student generated work
Yes________ No_______ Student's full first and last names

I understand that the Board of Education will not include the address, telephone number, social security number or student identification number of of a student on any BOE Web Pages.

Student Signature______________________________________ Date_____________

Parent/Guardian Signature ______________________________________ Date_____________

(Not Required if student is 18 years of age or older)

School Name______________________________________ Grade_____________

rev. 3/1/199


To The On-Line Presentation:
Setting Up A School Web Site

George Cassutto's Cyberlearning World

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