This authorization is for parents/legal guardians and all students under and over the age of 18. This authorization is to ensure you have received and reviewed the following important expectations and documents. For your convenience, this information is available in the BTCI Discord under Authorization and Documents. All Policies and Regulations updates can be found online at www.buildthecityinitiative.org/policies

1. You authorize the FORCE Program to request, acquire and store student information from the student's school or college. You authorize BTCI staff to contact the school/college, homeroom teacher, additional teachers, professors, guidance counselor(s), success coach(s) or other relevant school representatives to collect grades, test scores and day-to-day behavior.
2. You have the right to inspect and review the education records received by the school or college representatives upon request.
3. Student attendance is based on online participation. In order to complete the program, students must complete each and every assignment.
4. A Certificate of Program Completion is designed for a student who has earned all of the required standard units of credit for graduation out of the program.
5. You authorize and acknowledge students will go through Academic Counseling, Career Counseling and College Counseling in this program.
6. Academic counseling helps students and/or their parents or guardians complete and understand Academic expectations for the program, acquire knowledge of program curriculum choices and customizations, and prepare for academic success in schools to help transition into college, career, entrepreneurship and other educational opportunities. *optional*
7. Career counseling helps students acquire information and skills to plan for work, entrepreneurship, independent contracting and other career opportunities.
8. College counseling prepares students by incorporating scholarship and loan expectations into a financial management plan, preparing students for college entrance expectations and steps students should take to be accepted into the institution of their choice without the debt and stress that often consumes college students.
9. You authorize the FORCE Program and BTCI to know if you (or your child) has any illness or condition that will hinder your (or his or her) success in the program, such as ADHD, ADD, depression, anxiety or chronic issues that require lapses in workload completion.
10. You authorize to participate (or allow your child to participate) in mandatory program outcome assessments that focus on the program's SMART Goals and Objectives and intended student outcomes as shown on the organization website www.buildthecityinitiative.org/src/buildthecity.html. The assessments will be administered 3 times over the program duration (at the start, midway and at completion). We will ask the student periodically about their life and experiences related to their goals, as well as academic assessments. We also collect demographic information that helps us make local, state-wide and region-wide decisions. The information is used to help program staff working directly with students. By signing this authorization form, you indicate that you are the parent or guardian of the person named in this membership application and that you give your consent to and give authorization to participate (or allow your child to participate) in assessments used by Build The City Initiative, Inc.
11. You must give your permission for the assessments in order to register for the program. These assessments help us make sure we are guaranteeing your (or your child's) success. The second purpose of BTCI assessments is to report to community partners and supports the progress of the program and success of the students. The information is not used for any other purpose. There are no right or wrong answers in the outcome surveys (questions are about feelings, opinions, and experiences).
12. Copies of the assessments are available if you would like to review any of the questions being asked. To do so, you must inform the Executive Director of your Club.
13. Your private information and assessment responses will not be sold to any third party or organization. All information is kept confidential. See our privacy policy at www.buildthecityinitiative.org/src/privacypolicy.html.

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There is no cost to you to enroll in this program.

Build The City Initiative, Inc. does not discriminate against students with disabilities or injuries.