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Evaluation & Recommendation Permission  

Student Name 
      Present Grade        Age      Birthdate 
      Parent Name    
      City           State      Zip 

      Church Membership    
      Pastor or Elder  
      Current School 

      City                Zip    

      Teacher Name   
      Principal Name 

      Enter Code                       
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The Yakima Adventist Christian School student evaluation will include a telephone interview with the student's last teacher and principal.

I give my permission for a representative of the Yakima Adventist Christian School student 
evaluation committee to contact my child's school for academic, behavioral, and other 
information that will help teachers better understand the needs of my child.

   Parent/Guardian Signature 

   Your Email Address