From Classbrain.com's


About Movies in the Classroom
Basic Movie Permission Slip
By Melissa Gruber
Aug 15, 2006, 10:22 PST

www.NewLineShop.com


Your School
Movie/Video Permission Form


Request Date:__________________________________________

Teacher Name:_________________________________________

Name of Movie/Video:____________________________________

Rating on Movie/Video:___________________________________

Reason for showing the Movie/Video:________________________
___________________________________________________
___________________________________________________
___________________________________________________

Date of viewing:_________________________________________

Teacher Signature:_______________________________________

Student Name:__________________________________________

Parent/Guardian Approval:_________________________________


Your School
Movie/Video Permission Form



Request Date:__________________________________________

Teacher Name:__________________________________________

Name of Movie/Video:____________________________________

Rating on Movie/Video:___________________________________

Reason for showing the Movie/Video:________________________
___________________________________________________
___________________________________________________

Date of viewing:_________________________________________

Teacher Signature:_______________________________________

Student Name:__________________________________________

Parent/Guardian Approval:_________________________________



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