Parent Consent Form


Beyond Bullies E-teen leader program

Parent Consent Form

Dear Parent(s):

Your teenager is applying to the Beyond Bullies Online Teen Support Program. The program will broaden the life experiences of teens by helping them grow their compassion, tolerance and communication skills by offering them a chance to assist a peer who is bullied or cyberbullied. The program is headed by Melissa Sherman, Executive Director and Founder of Beyond Bullies.

We plan to offer several trainings during the year. The initial training will take approximately 3 hours. Ongoing trainings and materials will be required throughout the year. A one-year commitment three hours a week online is required. Teens can volunteer one day a week between 4:00 p.m. 7:00 p.m. Monday Sunday. All meetings between a teen leader and their peers will occur online.

Once the training is completed, your child will be able to begin working as a teen leader. If you support your teen's application to the Beyond Bullies training program, please print and sign this form.

If you have any questions, please call us at 310/720-6511. If you would like your child to participate in the mentoring program, please make sure to print the consent form.


Students Name _____________________________________________________


Grade _______

High School________________________

Parent: Print Name


Parent's Signature_______________________________________



Date ______________________


Melissa Sherman, Executive Director

The form must be signed and mailed to:

Beyond Bullies

8560 Whitworth Drive Suite 5

Los Angeles, CA 90035