Book: I

Section: Instruction

Title: Private School Student Application for Participation in Portland Public Schools Co Curricular Activities

Code: IHBGC-E1

Status: Active

Adopted: February 3, 2015

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PRIVATE SCHOOL STUDENT APPLICATION FOR PARTICIPATION IN PORTLAND PUBLIC SCHOOLS COCURRICULAR ACTIVITIES

 

The parent (or student if 18 years of age or older) must submit a separate application for each activity in which participation is desired. 

 

STUDENT INFORMATION

 

Student’s Name:

 

Student’s Date of Birth:

 

Grade in Private School:    

 

Student’s Address:  

 

Phone Number:

 

Parent/Guardian’s Name:

 

Private School Name:

 

Private School Address:

 

Private School Phone Number:

 

Private School Principal/Head’s Name:

 

Student is Applying for Participation in the Following Activity:

 

 

VERIFICATION OF ELIGIBILITY

 

I authorize ________________________ to provide to Portland Public Schools upon its

                        (Private School Name)

request all information necessary to verify that my son/daughter, ___________________

                                                                                                                        (Student Name)

meets the eligibility requirements for participation in the co-curricular activity that is the subject of this application

 

________________________________________                     ______________________

Parent’s Signature (or Student’s, if 18 or older)                          Date

 

STUDENT PARTICIPATION AGREEMENT

 

I agree to comply with all Portland Public Schools policies, administrative procedures, and behavioral, disciplinary, attendance and other rules that apply to Portland Public Schools students participating in the co-curricular activity that is the subject of this application.

 

 

________________________________________                     _______       

Student’s Signature                                                                          Date

 

IHBGC-E1 Private Sch Std App for Participation in PPS CoCurr Activities.pdf (9 KB)

 

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