Parent/Guardian Consent Form (EIU TVP SIP 25)

Parent/Guardian Name
Parent/Guardian of (student name)
Parent/Guardian Email
Parent/Guardian Phone Number Parent/Guardian Phone Number - ### - ### ####
Parent/Guardian Address Parent/Guardian Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
I consent to the student listed above participating in the EIU TVP Summer Immersion Program.

I consent to the student listed above participating in the EIU TVP Summer Immersion Program. Yes No