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Please print, fill out, sign and return this letter by mail to the address below. Scholastic Inc. 557 Broadway New York, NY 10012 Dear Scholastic: My name is In order for you to do a comprehensive check of your records, I understand that I need to provide you with the following information: My student's name is _________________________ [child's first and last name]. My student's e-mail address is _________________________ [child's e-mail address]. My student's individual user name is _________________________ [child's username]. The Scholastic website is _________________________ [fill in URL or web address]. The program or activity is _________________________ [fill in name of activity]. [Check boxes that are applicable:] Please use the box below to provide any additional details that may help us process your request: Please respond to this letter at the following address: By my signature, I affirm that I am a teacher of the child with the name and e-mail address that I have provided in this letter. I understand that from the information I have provided in this letter, you have no way of knowing whether this child is participating in a contest, sweepstakes or other activity using another name and e-mail address, or whether this child is participating in online classroom activities using a class-wide username and password. I also understand that if you have separately received consent from the student's parent for the student to participate in a program or activity, that you may limit your compliance with the requests in this letter to those programs or activities to which I have given consent, unless and until you are directed otherwise by the parent. Sincerely,
[your signature]
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