Consent Form for CAFN Education Staff

The purpose of this form is to allow you to give us your consent (or not) to release personal and confidential material related to your childrens.
Please check in the options below the right ones for you.

I provide consent for the release of my child(ren)’s educational records to enable the Yukon Department of Education to provide data to the Champagne and Aishihik First Nations Government, as follows:

You can list any other subjects/materials you would like your ESW to have access to:

All the information provided is kept confidential and access to these documents is restricted to CAFN Education Department Director and staff, on an as needed basis.

If at any time I wish to withdraw this consent, I will submit a letter to the Director of Education or the Education Support Worker indicating my withdrawal and for which student(s).

How many Children are you applying for?

Children 1 Data

Date of Birth

Children 2 Data

Date of Birth

Children 3 Data

Date of Birth

Children 4 Data

Date of Birth

Children 5 Data

Date of Birth

Signature of Parent/Guardian:

Date

Popular topics:

Popular topics:

Consent Form for CAFN Education Staff

Children 1 Data

Children 2 Data

Children 3 Data

Children 4 Data

Children 5 Data