Belle Isle Enterprise Middle School

Authorization

I, the undersigned, am the parent or guardian of:

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Name of child

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Date of birth of child

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SSN of child

I hereby give my permission for the release of the academic records of said child to any representative of the Belle Isle Enterprise Middle School. I also authorize any school

or school system to which this authorization is presented to accept a photocopy of this authorization rather than require the presentation of the original.

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Printed Name

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Signature