Donegal School District

Consent for Electronic Transmission of Forms, Records and Other Documents

I am the parent or legal guardian of _______________________________ and hereby consent to the electronic transmission of forms and records, and other documents that might contain personally-identifiable information concerning my child, to the following electronic mail address: _____________________________.  Information transmitted could include, if applicable, Individualized Educational Programs, Evaluation and Reevaluation Reports, Prior Written Notices, Procedural Safeguards Notices, and other documents related to special education programming.  

I understand that information transmitted to this address will not be encrypted or otherwise protected and that the security of that information after transmission is entirely my responsibility.  I also understand that this consent shall remain in effect unless and until it is revoked in writing by me and that written revocation is received by the school district.

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            Date Parent or Guardian Signature

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Printed Name of Parent or Guardian