This form must be submitted by an MSBA or IASA district member educator or administrator on behalf of their student(s). 

By submitting this form, (name of school) certifies that all student information provided to MSBA by (school) was obtained and disclosed to MSBA in accordance with the Family Educational Rights and Privacy Act. 

Once your form is submitted, please send your PDF and Video to  amanda.bohnert@smwilson.com

Thank you!