PantherCard
Proof of Identification for minors
I, the undersigned student, hereby attest that all of information presented below is factual.
Student
Name (printed):
Address:
Student ID:
Birth Date:
Phone:
Signature:
Date:
I, the undersigned Parent/Guardian-Attester, hereby attest that the above student is my son,
daughter, or ward, is the student identified above, and that all of the information on this form is
factual.
Parent/Guardian-Attester
Name (printed):
Address:
Phone:
Signature:
Date:
Witness:
Signature:
Date:
Attach a copy of the Attester’s Driver’s License to this document.
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