Forms

Review a list of directions for filling out the forms listed below. All forms are PDF files and can be viewed using Acrobat Reader.

Forms to be completed and returned to:

Virginia Governor's School for Agriculture
2270 Litton Reaves Hall
Blacksburg, VA 24061

The following forms need to be completed:

• Parent/Guardian and Student Acknowledgement Form
  This form acknowledges that the student and parent/guardian have read the handbooks and acceptable use guidelines.
  
  
• Scholar Survey
  This electronic form is interested in gaining student information and student interests.
  
  
• Student Information Sheet
  This form seeks to gain student contact and insurance information.
  
  
• Fieldtrip Permission Form
  This form authorizes parental permission for the student to participate in GSA fieldtrips.
  
  
• Supervision Release Form
  This form offers parental consent for the student to leave campus unsupervised for short periods of time.
  
  
• Public Relations and Student-Created Work Consent Form
  This form gives parental consent for the release of student-created work for public relations purposes.
  
  
• Parent or Guardian Waiver of Liability
  This form releases the Commonwealth of Virginia, the Virginia Department of Education, and Virginia Polytechnic and State University and their respective agents and employees from liability in the event of accident, harm, or injury.
  
  
• Authorization for Adminstering Prescription Medication
  This form authorizes the administration of prescription medication by the GSA.
  
  
• Acceptable Use Guidelines
  This form collects information to any individual using or administering Virginia Tech computer and/or communication facilities.
  
  
• Medical Consent and Information Form
  This form gives the GSA parental consent to provide medical treatment.
  
  
• Montgomery Regional Hospital Admission Information
  This form deals with admission information for a hospital visit.
  
  
• Permission for Medical Treatment and Release of Medical Record Information
  This form gives parental consent for the Montgomery Medical Center to provide medical treatment.
  
  
• RSVP Information
  This form requests RSVPs for Governor's School activities.
  
  
• Pick-Up Release Form
  If someone other than the student's parent or guardian pick them up during Parent's Weekend (June 9th and/or July 10th) or after graduation (June 23rd) a Pick -Up Release Form needs to be filled out.
  
  
• Virginia College of Osteophathic Medicine Release Form
  The scholars will visit the Virginia College of Osteopathic Medicine as part of their educational activities. This release form allows the college to take pictures of the students as the go on tours.
  
  
• Activity Fee Information
  This form describes the activity fee associated with the program.