Student Speaker's Form

STUDENT SPEAKER'S FORM

Purpose: This form requests permission for a student to deliver a prepared speech at a school-sponsored event. Completion of this form does not guarantee approval. The school retains the right to review, edit, postpone, or deny any speech that conflicts with school policy or student welfare.

Student Information

Event Information

Expected audience and setting:

Speech Proposal

Content Certification and Compliance

By submitting this form the signer certifies the following (check each applicable box and sign below where indicated):

I certify the speech content is original student work or appropriately attributed and quoted where applicable.

The speech will not be used for commercial solicitation, endorsement of products, or direct fundraising unless preapproved in writing by school administration.

The speech will not contain profanity, hate speech, threats, or content that discriminates based on protected characteristics.

I acknowledge that the school reserves the right to review the speech in whole or in part prior to presentation and to require revisions or deny permission if the speech is inconsistent with school policies. I understand that failure to comply may result in disciplinary action in accordance with school policy.

Parent / Guardian Information (Required if student is under 18)

Administrative Use Only

Approval decision:

Administrator signature recorded as: Date:

Acknowledgement and Signature

Indicate the capacity in which the signer is executing this form (check one):

Student (18 years or older)

Parent / Guardian (required if student is under 18)

Certification: I attest that the information provided is true and complete to the best of my knowledge. I understand the conditions and compliance obligations stated above and accept responsibility for the content presented. I further agree to cooperate with any administrative review and to make requested edits prior to public presentation.

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