Parent Consent Form

Goodwill : Industries of Wayne and Holmes Counties, Inc.
CONSENT FORM
Client Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I am providing permission to Goodwill to allow my child or ward, to sign their CCMEP Individual Service Plan, Comprehensive Assessment or any other forms related to the CCMEP Pathways to Success Program.
Parent or Guardian Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent or Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

I am providing permission to Goodwill to allow my child or ward, to sign their CCMEP Individual Service Plan, Comprehensive Assessment or any other forms related to the CCMEP Pathways to Success Program.