Parent/Guardian Permission

Study Skills Small Group: Six Weeks

Dear Parent/guardian

As a part of the counseling curriculum, I will be holding small groups for students who
show the need for extra support in various areas in their lives. The group I will be facilitating is a
study skills group, which has shown to be very effective in the past. Students who have shown
difficulty in two or more classes are encouraged to take part in these six small group sessions
which will focus on basic study skills, and hone in on other very relevant struggles attached to
studying such as note-taking techniques, how to use a planner, relaxation, organization, and a bit
of motivation. I appreciate your participation in this group if you choose to do so.

Sincerely,
Ms. Holliday

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I ____________________ give my student ________________________ permission to be a part

of this group. I understand that the students have been recommended for this group in order to
receive assistance with educational barriers that they have. I also understand that my child may
be pulled from the group at my discretion at any time if they are not making progress, and/or if
they begin to feel uncomfortable.

As the student I__________________________ understand that full confidentiality will be held

by the counselor, EXCEPT if something poses immediate harm/danger to myself, or others
around me. I also understand my participation in the group is highly encouraged, but NOT
required if any topic is uncomfortable.

__________________________________ ________________
Parent/Guardian Signature Date

__________________________________ _________________
Student Signature Date