VANCOUVER SCHOOL DISTRICT
Dr. Beverly Questad, VSD English, MUN, Debate and Speech Teacher
Skyview High School, 1300 NW 139th St., Vancouver, WA 98685
Phone: 360-313-4200 Email: bquestad@vansd.org Fax: 360-313-4201
http://skyview.vansd.org/bquestad/index.htm


Release of Personal Information
for Publication on Skyview High School
Intranet/Internet Web Pages and MUN, Debate and Speech Textbook


Student Name (Printed):__________________________________________

Country: ______________________ Committee:___________________________ 

I hereby grant the Vancouver School District permission to use the following information on the VSD Model United Nations Website and in the MUN, Debate and Speech Textbook which are published on district servers:

Student name
Student quotes or work ( with student editing privileges)
Photograph
Year in school

I reserve the right to retract this permission at any time. Retraction must be made in an email (bquestad@vansd.org), in writing to Dr. Questad or to the district Web Manager. Deletion of information will be made within five working days of receipt of the acknowledged request for retraction unless an emergency exists.

Parent Signature___________________________________             Date __/__/__

Student Signature__________________________________             Date __/__/__

I DO NOT grant the school district permission to publish my student's name, photograph and/or year in school.

Parent Signature___________________________________             Date __/__/__

Student Signature__________________________________             Date __/__/__


Please return this form to Dr. Questad
Thank You.