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Release of info- print on BLUE -other.pdf
Handle: Document-97060
Owner: Rude, Megan (User-3313, 10933:EVERETT)DS
Tuesday, May 8, 2018 11:51:19 AM PDT
Friday, February 18, 2022 12:44:50 PM PST
Modified By:
Locked By:
  • Snohomish County Early Childhood Education and Assistance Program
Consent for Release of Information Revised July 2009Child’s Name: Date of Birth:Site:Directions: Obtain parent/guardian signature for ONLY ONE consent/release section per form.
  • General Release of Confidential Information (check only one box per form)
I authorize ECEAP staff to release information to school district personnel including kindergarten staff to facilitate my child’s transition tokindergarten.
  • Information to be published
includes:Name: Child’s Name:Occupation:Address:Home phone: ...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
Release of info- print on BLUE -other.pdf
No
4
123001
No
Appears In: 02. ROI Forms
Preferred Version: Release of info- print on BLUE -other.pdf