Date:October 1, 2002
Dear Parent/Guardian:
I am a student at Appalachian State University, and I am working in your child's class as an intern. As a part of my class work, I may be required to shoot videotape, take photos or audiotape in the classroom. I may also copy (photocopy, scan, videotape or photograph) student work.
Any products I create will be reviewed by my professors at Appalachian
State University who will handle the material confidentially. Please
indicate below if it is permissible to include your child on videotape,
in photographs and/or on audiotape, and return this to me by 10-09-02.
Thank you for your cooperation and assistance.
Sincerely,
Miss Katie Neely
________________________________________________________________
Student Name:______________________________________
Check appropriate response:
_____Yes, my child may be videotaped, audiotaped or photographed.
_____No, my child may not be videotaped, audiotaped or photographed.
Parent/guardian signature:_______________________________ Date: _______