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Parent Agreement Form

Compass Parent Agreement Form

The parent agreement form is to be completed by the student’s parents or legal guardians. If the student resides with parents in separate households, the form is to be completed by the parent/guardian with legal custody. In cases of split custody, both parents are required to complete the form. We ask that you write 3-5 sentences in the written responses below to give us a better understanding of your child.

PLEASE NOTE: this form does NOT save automatically. If you close out of your window, all content in the form will be lost. We recommend that you type your answers on a separate document then copy and paste them into this form.

1. Student's name:

2. Parent/Guardian Name (First):

3. Parent/Guardian Middle Name:

4. Parent/Guardian Last Name:

5. Address:

6. City/Town:

7. State:

8. Zip Code:

9. Phone Number

10. Parent/Guardian Email Address:

11. Applicant resides with:

Mother
Father
Both
Other

12. If "other" please explain:

13. Why do you support your child's participation in the Compass program?

14. What is your understanding of the Compass program?