PS 180 Digital Blue Card 2020-2021

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This digital blue card is for students attending PS/IS 180 Hugo Newman College Preparatory School for the 2020-2021 school year. This is equivalent to the emergency blue card you complete at the beginning of every school year.

Please complete for each child you have attending our school.

What grade is your student in? *

Student's Last Name: *

Student's First Name: *

What cohort is your student in? *

Cohort A

Cohort B

Cohort C

Cohort D (Fully Remote)

I don't know.

Student's Date of Birth: *

YYYY

Student Gender: *

Female

Male

This student resides with... (Check all that apply) *

Mother

Father

Grandmother

Grandfather

Aunt or Uncle

Foster Parent

Other:

Required

I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, movies or video tapes of the student mentioned above. I also grant to the right to edit, use, and reuse said products for nonprofit purposes including use in print, on the internet, and all other forms of media. I also hereby release the New York City Department of Education and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. *

Yes, I grant permission for this child/student to be photographed or filmed.

No, I do NOT grant permission for this child/student to be photographed or filmed.

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