SCHOOL RECORD WAIVER Submit your School Record Waiver Form We will reach out promptly Disclaimer As the Parent/Legal Guardian, I understand that Chawathil First Nation provides Educational services and benefits to my child. Chawathil First Nation must have specific information to provide these services and benefits. By signing this form, I am allowing Chawathil First Nation to exchange certain information with School District 78 and Seabird Island Independent Schools, so it will be easier to provide or coordinate services or benefits. STUDENT 1 - First Name Last Name Date of Birth Band Registered With Status Number Residence On Reserve Off Reserve Home Address Email Phone Number School Attending Silver Creek Coquihalla Hope Secondary TREC Continuing Education Open Learning/Online Lalme'lwesawtexw Community School Seabird Island Community School Other If Other Please State Student Grade Did you receive funding last year? Yes No Last School Attended STUDENT 2 - First Name Last Name Date of Birth Band Registered With Status Number Residence On Reserve Off Reserve Home Address Email Phone Number School Attending Silver Creek Coquihalla Hope Secondary TREC Continuing Education Open Learning/Online Lalme'lwesawtexw Community School Seabird Island Community School Other If Other Please State Student Grade Did you receive funding last year? Yes No Last School Attended STUDENT 3 - First Name Last Name Date of Birth Band Registered With Status Number Residence On Reserve Off Reserve Home Address Email Phone Number School Attending Silver Creek Coquihalla Hope Secondary TREC Continuing Education Open Learning/Online Lalme'lwesawtexw Community School Seabird Island Community School Other If Other Please State Student Grade Did you receive funding last year? Yes No Last School Attended Disclaimer By signing this, I hereby authorize the school registrar to release information concerning, change of address, student attendance, student transcript information, student progress and grades. Parent Name Date Parent Has Signed Send Our Board of Directors Lorem ipsum dolor sit amet Nick PatersonSupport Staff Alicia AndersonSupport Staff Michael ClarkSupport Staff Stacy HendersonSupport Staff Volunteers 0 Donations 0 Projects 0 Missions 0
