Name of Person
School District Name
Address (Street, or PO Box No.)
City, State, Zip Code

RE: Child's full name
Date of birth

Dear :

We are the parents of (child's name), who is currently attending (name of school), in the (type of class or grade).

Our understanding of our (meeting or phone conversation) on (date) is: (state your interpretation).

If you have not contacted us within ten (10) days we will assume our understanding is correct.

Sincerely,

Your Name
Phone Number

cc: Student's Permanent School File