What is the student's first and last name?
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First Name
Last Name
What is the parent/guardian's first and last name?
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First Name
Last Name
What are the dates of the class the student attended or will be attending?
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Did you watch the entire parent meeting video?
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yes
no
By electronically signing below, you are confirming that you have watched the 38-hour parent course video. You understand all information provided in the video and agree to all requirements of the parent and student as detailed in the video above.
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Today's Date:
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-
Month
-
Day
Year
Date
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