University of Georgia-TS-High School Application Form

Educational Talent Search

High School Application

Authorization
Authorization
for
Release of Student’s Records, Information and
Permission to Photograph/Video Student

Privacy Act
In accordance with the Family Educational Rights and Privacy Act, I understand that all information concerning my child and me is confidential and will not be revealed to anyone except Educational Talent Search Program Personnel.

I, {parentName95} Parent/Legal Guardian of ,(Please Print) (Please Print) authorize the Superintendent of Schools or her/his Designee(s) to release all records listed below to the following Agency and its Designee(s):

Records:
Attendance Data
Psychological Education Reports Testing Data
Health Records
Grade Transcripts/Progress Reports Special Education Placement Data Student Clearinghouse
Social Security Numbers

University of Georgia TRIO Educational Talent Search 243 Milledge Hall Athens, Georgia 30602-1550
(706) 542-7640 (Telephone)
(706) 583-8246 (Fax)

Student Schedules
I further authorize the release of all information regarding my child’s educational, physical and social adjustments in school, as long as s/he participates in the Educational Talent Search Program.

I also understand that prior to transfer, I may review and have all/any part of these records properly interpreted by making such request of the Principal or appropriate Board of Education Personnel.
Parent Name*

First NameLast Name
Student Name*

First NameLast Name
Permission to Photograph/Video Student: I agree to allow ETS and its constituents to photograph or digitally record my child for use in publication.*

YesNo
Student Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
mm-dd-yyyy

High School Contract
University of Georgia

High School Contract

As a student in the University of Georgia’s Educational Talent Search Project and as a major objective of ETS is to assist me with successful completion of secondary school and postsecondary planning/placement, I agree to:
1. Follow my Individual Development (IDP)
2. Give my ETS Program Specialist all mid-term/nine weeks report cards and transcripts.
3. Discuss my changes in my academic plan with my parent (s) and ETS Program Coordinator.
4. Participate in career/educational activities, tours and workshops.
5. Discuss my career aspirations and postsecondary plans with my parent(s).
6. Register and take the ACT/SAT as recommended by my Program Specialist.
7. Research at least three (3) postsecondary institutions by completion of the eleventh (11th) grade.
8. As the parent(s) of an ETS student, I agree to participate in and support ETS and parents activities including chaperoning field trips, parent orientations as well as Parent Advisory Board meet
NOTE: If a student is to fully gain from the services offered by ETS, it is imperative that he/she attends counseling and academic sessions, school workshops, in addition to cultural /educational tours. All services offered by ETS are contingent upon one another. Failure to fulfill contract agreement could result in termination from ETS.
*Student Initial Here to Acknowledge Reading of Contract
*Parent/Guardian Initial Here to Acknowledge Reading of Contract

Parent Association
University of Georgia Educational Talent Search Parent Association

Parent/Guardian participation is critical to student success. As a member of our Parent Association, your assistance will help strengthen our program. If you are interested in serving please complete the following.
Parent Name

First NameLast Name
Email
example@example.com
Phone
Preferred method of contact (please select):

PhoneEmail
Are you interested in leadership role in Association (please select):

YesNoMaybe

Educational Talent Search