APSC 110 Lecture : irvine.pdf
Document Summary
The information collected in the shaded area will be protected under the freedom of information and protection and privacy act. Questions about collection and use of this information should be directed to the principal of your school or the information and privacy. Complete all areas of this form; use n/a if not applicable to you. (advisory) teacher. Student social worker" name & phone (if applicable) Photo id (parents do not send photo unless requested) List any medical conditions, severe allergies, medical information or any instructions. In the event of an earthquake or other serious emergency, the school may implement a controlled release of students for their safety and well-being. Should this be necessary, the school will only release your child to persons authorized on this form, or if necessary, to emergency medical personnel. Persons below are authorized to pick up the above student should either parent / guardian be unable to reach the school.
