Parent Permission Form

Note: The Educational Talent Search Program is federally funded by the U.S. Department of Education. Consequently, certain information is required. The information you give, however is held strictly confidential by the program staff and it will not be released to anyone without your written permission.

Student’s Name ________________________________________ Social Security #______________

School__________________ Parent(s) Name ___________________________________________

Address __________________________________________________________________________
( street) (city) (state) (zip)

Home Phone:_________________________ Work Phone:________________________________

I hereby give permission for ________________________________________________________ to
participate in the Educational Talent Search Program which will provide tutoring, field trips, and
support services. I also give permission for the Talent Search Program to secure my child’s school records in order to verify his/her academic improvement and financial information for participation in the program. I agree to provide a copy of an official document to verify my child’s eligibility.

Parent/Guardian Signature:________________________________________Date:___/______/_____