503.07 E1- Report Of Student Disclosure Of Identity

Dear (Parent/Guardian) _________________,

 

This letter is to inform you that your student (student’s name listed on registration) ________________

has made a request of a licensed employee to (check all that apply):

 

______ make an accommodation that is intended to affirm the student’s gender identity as follows:

___________________________________________________________________________________

___________________________________________________________________________________

 

______ use a name, pronoun or gender identity that is different from the name, pronoun and/or gender

identity listed on the student’s school registration forms. The name, pronoun, or gender identity

requested is _________________________________________________________________________.

 

If you would like to amend the student’s registration paperwork to permit the student’s requested

accommodation and/or include the use of the above-referenced name/pronoun/gender identity, please

complete the attached form and return it to the district administration office.

Sincerely,

 

____________________________________________ __________________

Administrator                                                                    Date

 

Approved: September 18, 2023

Reviewed: September 18, 2023

Revised: September 18, 2023