Passion to Purpose Scholarship Program Parent/Legal Guardian Consent Form 2022/2023 Please fill out this form, print, sign, and email it to us at hello@edynamiclearning.com
Please type or print legibly. Student’s Name _____________________________________________________________________ Grade ________________ Student’s School Name ______________________________________________________________________________________ School District Name _________________________________________________________________ State _________________ Name of Teacher Submitting Teacher Endorsement Form ______________________________________________________ Teacher’s Email Address _____________________________________________________________________________________ The essay submitted to the Passion to Purpose Scholarship Program by the student named above is an original work by the student. The submission of the Parent/Legal Guardian Consent Form constitutes permission from the student entrant’s parent or legal guardian for eDynamic Learning to use the student’s first name and last initial, have the right to publish, promote, and otherwise use the essay without permission, notice or further compensation. All essays become the sole property of eDynamic Learning. By signing this below, I acknowledge that I have read the Contest Rules and information prior to signing this document and that I understand the content of the rules and information. Parent/Legal Guardian Signature _____________________________________________________________________________ Printed Name _______________________________________________________________________ Date __________________ Parent/Legal Guardian Email Address _________________________________________________________________________ Parent/Legal Guardian Phone Number (______) ________-________________ Please check this box if the student has a documented Individualized Education Plan (IEP), 504 Accommodation Plan, or disability.
Questions?
Please contact hello@edynamiclearning.com