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Parent Information
  
Include area code. Numbers only. No dashes, brackets or spaces.
Include area code. Numbers only. No dashes, brackets or spaces.
  
Include area code. Numbers only. No dashes, brackets or spaces.
Include area code. Numbers only. No dashes, brackets or spaces.

Please read and enter your name below signifying that you agree with the following statement:

I/We give permission to the Educational Talent Search (ETS) program at Cal Poly to access any school or financial records of my student to determine: eligibility for the program; status and progress in middle, secondary and post-secondary education; and eligibility for financial aid. In addition, I give my permission for my child's name, photograph, work and/or statements to be used by ETS for promotional, publicity or instructional purposes in print and/or electronic formats. 

My student has the permission to participate in field trips planned for and supervised by ETS. Furthermore, should my student require medical attention and/or care while participating in ETS, I give my consent to medical examination and necessary treatment, including drugs, x-rays, and surgery as may be deemed necessary by the attending physician. This consent shall remain effective so long as my student is a participant in ETS. Should an emergency arise, staff will attempt to reach me and be guided by my wishes. In the event that I cannot be contacted, the attending physician has my consent to act as medical judgment may indicate. 

All information provided in this application is accurate to the best of my knowledge. 

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