Parent Permission Form

Junior Statesmen of America

The Lewisville High School chapter of J.S.A. is an excellent way to achieve high standards of citizenship, improve understanding of democratic processes, develop responsibility in the individual, and promote involvement in the community.

Location of meetings: ____________Room 2565________________________

Meeting schedule: ____________Wednesdays 4-5 pm_______________________

Sponsors name: ____________Mr. D. Ryan_______________________________

Student name: _______________________________________________________

Mailing Address: _______________________________________________________

Email Address:(please print Carefully)_______________________________________________________

Phone Number: _______________________________________________________

Parent/Guardian Signature (signature grants permission for your son/daughter to participate in J.S.A):

__required(X)_____________________________________________

Dues are $5. -- ($3 of annual dues goes to the national J.S.A organization.)

For more information on J.S.A go to www.jsa.org