February 15th, 2012 | Published in News
Student Registration: PENNCREST SCHOOL DISTRICT
Secondary GIFTED PROGRAM
Name: _______________________________ School Building____________________
Grade student will be in during 2012-2013 school year: __________________________
Contact Phone Number: ___________ ________ _____________
Seminar Selections: Please select the seminar option of your choice below.
[ ] Allegheny College
Select your THREE preferences for each session time by indicating the appropriate SEMINAR LETTER. You must select at least one preference for each session time for registration. You MUST make a first, second and third choice for each time session.
Session #1 _______ or _______or _______
Session #2 _______ or _______or _______
Session #3 _______ or _______or _______
Signatures: Student’s _____________________________________________
Return the registration form and media release consent form to Mr. Nicolazzo, or Mr. Harakal by Thursday, March 29, 2012_ (Note: Classes fill up quickly. In the case of too many students, registration is on a first come, first serve basis for first choice! Please return the registration forms as soon as possible!) If you miss the registration deadline and would still like to attend, contact Mr. Nicolazzo (email@example.com) or Mr. Harakal (firstname.lastname@example.org) to see what is still available.
Media Release Consent Form
Office of Public Affaires
520 North Main Street
Meadville, PA 16335
Student Name: _____________________________________________
School Location: ____________________________________________
Dear Parent of Guardian:
Allegheny College periodically receives requests for newspapers, magazines, and television and radio stations for stories concerning school-related activities. Often, such requests include permission for students’ names and/or pictures to be used as a part of a news account or a feature story.
In order to ensure that we have your permission to
Release your child’s name and/or picture to the media, the College needs your written consent. Please indicate below whether or not you will consent to the release of your child’s name and/or picture for the purposes stated above and return this form to your child’s teacher.
________I grant permission for my child’s name and /or picture to be used in newspaper, magazine, television and/or radio coverage and stories concerning school-related activities at Allegheny College.
________I further agree to hold the College and its Board of Trustees, employees and agents, harmless should I have any claim regarding the use of my child’s name and/or picture in any type of news coverage stories.
________I do not grant permission for the release of my child’s name or picture for the reasons stated above. I understand that this will prevent my child from receiving recognition for accomplishments through the channels described.
Parent or Guardian’s Name
Parent or Guardian’s Address