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AUTHORIZATION FOR RELEASE OF INFORMATION
SENIOR EXIT PORTFOLIO
(to be placed after the cover page inside the portfolio)
I hereby authorize: Newton High SchooVUSD #373
To disclose or deUver: Student's Senior Exit Portfolio to his/her interview committee.
The foUowing information from the records of: ~ . (Name ofstudent)
X Senior Exit Portfolio
THIS RELEASE IS AUTHORIZED FOR THE CURRENT SCHOOL YEAR (2009-2010)
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Date
~, 2-, I 2.cx.,~
Date
Guardian (if student is less than 18 years of age)
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