Washington County Board of Education Parent/Guardian Form for
Including Student Likeness/Name/Work on WCBOE Internet Web Sites

Washington County Board of Education Guidelines for Web Pages requires parent/guardian and
student permission for any of the following to be published on WCBOE 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 Washington County Board of Education 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 Washington County Board of Education will not include the address, telephone number, social security number or student identification number of of a student on any WCBOE 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 Washington County Public Schools: http://www.wcboe.k12.md.us
To North Hagerstown High School: /nhhs/