If student is below age 18, a parent or guardian must submit a consent form for the student to participate in APV’s Credit Recovery courses.

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Child's Name *

First

Last

Child's Current Home School

Parent Name *

First

Last

Parent Email *

Parent Phone

Emergency Contact Number *

Special Instructions

Parental Consent for Child

• Yes, I provide consent.
• No, I do not provide consent.

Date of permission

Parent or Guardian Signature

Clear Signature

Submit