The following student is applying for admission to the Virtual Learning Academy Charter School Adult Education Diploma Program. The Virtual Learning Academy Charter School is required to obtain written consent from the student before personally identifiable information from a student's education records is disclosed to any party other than those who are permitted access by law. Consent is also required before personally identifiable information is used for any other purpose than to aid in the planning for and provision of appropriate educational services to the student.
Please indicate your response to this request by checking the box, which reflects your decision, and then sign the document in the space provided. A copy of the records to be released will be provided to you upon request. Thank you.