INDEPENDENT SCHOOL DISTRICT 196
Rosemount, Minnesota
Educating our students to reach their full potential
Series Number
Title
503.6.1P
Adopted
May 1998
Revised
Permission for Student Work to be Published on the District 196 World
Wide Web Server
Name of Student
School
School Year
Parent, Guardian or Adult Student (age 18 or older): Please check one of the
two items below, complete the rest of this form and return it to your student’s
teacher. Thank you.
I grant permission for work created by the student named above to be
published on the District 196 World Wide Web server. I understand that
the district’s web server provides information about school and district
programs to students, staff and the general public, and that only the
student’s first name and the school name are used.
I do not grant permission for work created by the student named above to
be published on the District 196 World Wide Web server.
Signature of Parent, Guardian or Adult Student (Age 18 or Older)
procedure 503.6.1P
Graphic Arts/6-1-98
Date