Copy of SCHOOL RECORD AUTHORIZATION Logo
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  • I have voluntarily elected to utilize David Boruchowitz as an advocate for my child through the Pahrump Disability Outreach Program (PDOP). As such I make the following authorization for the Nye County School District to release information and discuss my child and their education, and educational records in accordance with the release below.

     I have elected to use this advocate and authorize my advocate to communicate by e-mail and phone with the Nye County School District on my behalf before, during and after an IEP meeting. I understand that the Nye County School District has established a policy that they will only accept this communication concerning my child’s educational needs prior to and after IEP meetings only if I am copied on each e-mail communication he has with the Nye County School District. I understand that the Nye County School District won’t engage in phone calls with my advocate regarding my child’s educational needs unless I am on the call as well. I understand that the school district will only proceed with IEP meetings if I am present.

     I understand that I have a right to revoke this authorization at any time. I understand that if I revoke this authorization I must do so in writing and present my written revocation to the School in which the authorization was signed. I understand that the revocation will not be able to apply to information released prior to the revocation in response to this authorization.

     A copy of this Authorization shall be as valid as the original. This authorization is effective immediately and expires one year from the date below.

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