I authorize Special School District No. 1, Minneapolis Public Schools, to release written and verbal information to, obtain written and verbal information from, to allow the agency/person to schedule a time with the school to see the student at school during non-academic time, and allow secured on-line access to student data and obtain on-line reports of interventions and interactions from:
The information to be released will be student name, address, telephone, photograph, date of birth, dates of attendance, grade, current school, student ID, and the information I initial below:
1) I understand that this consent takes effect the day that I sign it. It expires on
or one year from the date of my signature.
2) I may change this consent at any time by sending a written notice to the releasing agency.
3) School officials may disclose this information if authorized or required by law to do so. A photocopy of this completed form is as valid as the original.
Parent Signature (or Student, if of legal age)Month/Day/Year Signed release does not guarantee access to student data through the Community Partner Portal. Final access is at the discretion of Minneapolis Public Schools.