343.4 Exhibit 2

School District of Prairie Farm

YOUTH OPTIONS PROGRAM PARENT GUARDIAN FORM

Student:

Grade:

Parent/Guardian Name:

Address:

Please include your feelings about your student’s request for involvement in the Youth Option Program.

          1. Is your son/daughter academically responsible enough to  handle this program?  Please explain.

          2. How will this program benefit your son/daughter?

I am aware of the District’s policies in regards to tuition payment and reimbursement.

Parent/Guardian Signature