Code of Honor Acknowledgement of Receipt

Code of Honor

Acknowledgement of Receipt
For a copy of the Code of Honor, please visit this link: https://www.i3academy.org/CodeOfHonor

I hereby acknowledge that I have received i3 Academy’s Code of Honor and agree
to support the tenets of the code. I will be responsible for fulfilling my obligations as
a willing partner in the education of my i3 student(s).

I understand that not adhering to all of the requirements set forth within the Code
of Honor may result in disciplinary actions for my child including and up to my
student being administratively withdrawn from i3 Academy.

I certify that this is a true and correct statement by my signature below:
Parent Name *

First Name Last Name
Signature *

Clear
Date

Month Day Year
Date
Hour Minutes AM/PM Option
Student #1 Name *

First Name Last Name
Student #1 Grade *
Student #2 Name

First Name Last Name
Student #2 Grade
Student #3 Name

First Name Last Name
Student #3 Grade
Student #4 Name

First Name Last Name
Student #4 Grade
Student #5 Name

First Name Last Name
Student #5 Grade
Should be Empty: