Student Name:
Student ID:
School:
Parent Name:
Parent Email:
 
By completeing and submiting this form, I hearby request the county school release my child for one period of the school day.
I also acknowledge that the Georgia Community Learning Center will not provide or supervise transportation to and from the class location.

2010 Participating schools: Archer, Central Gwinnett, Collins Hill, Dacula, Duluth, Mill Creek,
North Gwinnett, Parkview, Peachtree Ridge, Shiloh, South Gwinnett