August 24, 2020

Dear Parents or Guardians,

It has been a pleasure to work with your child this school year! As a visitor to your child’s classroom, I
would like to obtain your permission to capture teachable moments to remember and enjoy in the years
to come. Please check the following boxes and provide signatures to confirm that your son/daughter has
your permission for their photograph(s) and student work to appear in my professional student
teaching portfolio, which will be presented to the faculty at Saint Francis University at the conclusion of
my student teaching experience.

 Photo Release Permission

I hereby authorize (insert Name) to obtain and release photos and/or video images for the
purpose of producing a professional portfolio as a requirement for student teaching at Saint
Francis University.

 Publishing Student Work

I hereby authorize (insert Name) to obtain, copy, and publish my child’s academic work for the
purpose of producing a professional portfolio as a requirement for student teaching at Saint
Francis University.

Student’s Name: ___________________________________________

Parent’s/Guardian’s Signature: _________________________________________

Parent’s/Guardian’s Signature: _________________________________________

Thank you,

Cody Ebersole

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