503.7E1 Report of Student Disclosure of Identity

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