SAVE Prescott, Inc. Students Against Violence Everyday Participating Professionals Consent Form

Name: _______________________________________________________________________ Phone: _______________________________________________________________________ Email: _______________________________________________________________________   Address: _______________________________________________________________________ _______________________________________________________________________ Specialize In: _______________________________________________________________________

As a SAVE professional, I understand that I will not be asked to provide services for more than one student at a time. I understand that my involvement with SAVE warrants a background check performed by the school district. School officials will contact me with details regarding this matter. I agree to the placement of my name in the local newspaper as a SAVE supporter.

________________________________________ Signature of SAVE Professional

Please mail completed consent forms to the following address: