PAL PROGRAM WAIVER Renuncia al Programa PAL Gadsden Independent School District School /Escuela _________________________________ Date / Fecha ____________ Student / Estudiante ____________________________________________ ID # / # ID ___________ Grade /Grado _______ PAL Teacher / Maestro(a) de PAL __________________________________

The PAL services have been explained to me, and I am aware that my son/daughter qualifies for PAL (Program for the Acquisition of Language). However, I prefer that my child not participate in this program. _____________________________________ Signature of Parent or Guardian

_________________________ Date

Se me han explicado los servicios de PAL (Programa para la Adquisición del Lenguaje) y entiendo que mi hijo/a puede participar en este programa. Sin embargo, prefiero que no participe. ______________________________________ Firma del Padre de Familia o Tutor

_________________________ Fecha

I have explained the services of the PAL Program to the parent(s). He explicado los servicios del Programa PAL al padre de familia. ________________________________________ Signature of Principal/Firma del Director/a

_______________________ Date/Fecha

GISD: AY 2010 - 2011