100BMNM Education Tracking Portal
 

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PARENT ATTESTATION

This Parent Attestation Form is a "one-time promise" that you the parent or guardian will confirm to enter accurate and timely data related to your son(s) for the Success Academy (MOT Program)

all fields required 

I,  hereby attest that the information I will enter related to my son(s) here named

1

2

Enter Participant Name(s)

3 4

for the North Metro Success Academy, Career Academy and Men of Tomorrow Mentoring Sessions are accurate and complete to the best of my knowledge. I also commit that I will enter the information in a timely manner as requested by the 100 Black of North Metro and their agents.

Complete the fields below to indicate that you have read, understand and confirm your agreement to the above statements.


Enter Your Full Name


Enter Your Email Address

Last 4 Digits 
of Your Cell #

All information is required.

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