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Evaluation & Recommendation Permission  
  

    
Student Name 
      Present Grade        Age      Birthdate 
      Parent Name    
      Address 
      City           State      Zip 
      Phone  

      Church Membership    
      Pastor or Elder  
    Phone 
      
      Current School 

      City                Zip    
      Phone 

      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  
   Date