Parent Consent Form

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

MonthDayYear
Date
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
Date
Parent or Guardian Signature*

Clear
Date*

MonthDayYear
Date
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.