Student Grade Verification Form

 Proof of Eligibility for After-School Athletics, Clubs and Activities

Student Name:  _____________________________________ Date:  ____________

Name of Activity:  ________________________Coach/Advisor:  _______________

Follow the steps below and submit this form to the coach/advisor:

1.     Attach current grade print-out to this form and  circle  the date on the print-out.

2.     Complete the following checklist.  The attached grade profile shows:

_____I have all grades of C- or above. I may participate.

_____I have 1 grade in the D range and all other grades are C- or above. I may

      participate.

_____I have more than one grade in the D range and will work to improve my

grades in order to meet eligibility.  I will resubmit these forms when my

grades improve.

_____I have 1 or more grade of F and will work to improve my grades in order to

      meet eligibility.  I will resubmit these forms when my grades improve.

3.     Sign this form and submit it with the grade print-out to the coach or activity advisor.

______________________________________

                                                                          student signature

 Note:  This definition of eligibility updates the definition noted in the parent-student handbook. Modifications were made 9/2012.