TO ALL PARENTS AND GUARDIANS:

The Salem School District can be located on the Internet at http://www.salemschooldistrictnh.com. As a part of our home page we would like to include artwork and writing by students at all grade levels. If you would like to have your child’s work considered for inclusion on the home page, please sign below and return this form to your child’s school. Thank you.

______YES, I DO ALLOW MY CHILD TO CONTRIBUTE HIS/HER ARTWORK AND WRITING TO BE DISPLAYED ON THE SALEM SCHOOL DISTRICT WEB PAGE.

Student:_______________________School:_________ Grade:_____ RM:______

_______________________________________

Signature of Parent or Guardian

DATE:______________

______NO, I DO NOT wish to allow my child to contribute his/her work to the Salem School District Home Page.

Student:_______________________School:_______ Grade:___ RM:_____

_______________________________________

Signature of Parent or Guardian

DATE:_____________

The Salem School district does not discriminate on the basis of sex, race, creed, color or national origin in its educational programs or activities, including admission and employment, in compliance with Title IX (Educational Amendments 1973) and Title VII (Civil Rights Act 1964). Inquiries concerning application of Title IX and VII may be referred to 38 Geremonty Drive, Salem, New Hampshire 03079.