Glenbard Township High School District 87
Policy 6:210-R1
Instruction
Exhibit – Parental Permission for Instructional Materials
Dear Parents:
_______________________________________________________is going to view a portion of the movie
(Name of class)
__________________________________________ on________________________________________ .
(Title of movie) (Date)
This movie is rated “R” by the Motion Picture Association of America. This movie is being shown to
your student for the following curriculum reasons:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
You may request that your student not see this movie by signing the bottom of this letter and
returning it by __________________________.
(Date)
Your student will be given an alternative assignment and will be sent to another classroom/building
area for the period of time this movie is to be shown. If you have any questions about this letter,
please telephone me as soon as possible at _____________________.
(Teacher telephone)
PARENT RESPONSE
I do not want my student____________________________________________ to view this movie.
(Student’s name)
_______________________________________________________________________________________
Parent Signature
____________________________________
Date signed
DATED: April 11, 2005
REVIEWED: January 17, 2006
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