AUTHORIZATION TO EXCHANGE INFORMATION

with my student's teachers, counselors, physicians, and others that the Academy deems appropriate for the benefit of my student. I also authorize my student's teachers, counselors, physicians, and others to provide information to The Academy including confidential disclosures that they deem appropriate in their discretion for the tutoring and instruction of my student. I believe that this mutual exchange of information is necessary and appropriate for the purpose of providing the very best educational experience to my student. Please select one of the options below:
Students *
Students
School Phone *
School Phone