Maimonides School
The Maimo Experience

Yeshiva League Substance Abuse Initiative Permission Form


For Parents With Children Age 17 or Younger:
I do/do not wish for my child (insert name below) to participate in The Yeshiva League Substance Use Initiative. (Please click on correct button below).
I Do
I Do Not
Child's Name
I understand that the data will be fully anonymous, and that the purpose of the survey is for research purposes only.  No disciplinary consequence will be generated for any student as a result of participation or non-participation in this survey.
Signature (Please type in first and last name, which will be processed as your official signature).
For Students Aged 18 and Older
I do/do not wish to participate in The Yeshiva League Substance Use Initiative. (Please click on correct button below).
I Do
I Do Not
Student's First and Last Name
I understand that the data will be fully anonymous, and that the purpose of the survey is for research purposes only.  No disciplinary consequence will be generated for any student as a result of participation or non-participation in this survey.
Signature (Please type in first and last name, which will be processed as your official signature)

As an added security measure, please enter the following text in the box below.
 

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