School Start Times Testimonials

Testimonial Release

I hereby grant permission for my testimonial on school start times to be reproduced, used, and/or published by the New Jersey Chapter, American Academy of Pediatrics' (NJAAP) Task Force on Adolescent Sleep and School Start Times for the purpose of advocating for healthy school hours as outlined in Bill A3116/S2012 (Requires certain public schools that receive State aid to begin regular instruction for high school students no earlier than 8:30 AM). I acknowledge that my testimonial may be shared with NJAAP staff and leadership and state legislators, as well as publicly on the NJAAP website and social media, and other print and electronic materials for this purpose.

I understand that by signing this waiver, I make no claims or demands about the use of this testimonial.
I have read and understood the content of this testimonial release form and agree to its terms:(Required.)
Date:(Required.)
First Name:(Required.)
Last Name:(Required.)
Credentials (if applicable; i.e. MEd, PhD, MD, RN, MSW, etc.):
Email Address:(Required.)