GSA Forms

Congratulations on your acceptance into the Virginia Governor's School for Agriculture. The following forms are to be filled out and submitted to VGSA prior to participants attending the program. The forms are to be downloaded, completed, signed, and uploaded online by June 15th, 2024. 

Once all students have accepted their offer to attend VGSA, an email will be sent to students with instructions for uploading their forms and other steps necessary to complete their registration.

All forms should be filled out and signed electronically. Forms have been formatted to be fillable PDF files. Please use Adobe Acrobat Reader to complete the forms; a free download of the software is available.

Before completing the following forms, please thoughtfully review the 2024 Student and Parent/Guardian Handbook and the Acceptable Use of Information Systems at Virginia Tech webpage.

Code of Conduct for Virginia Tech Programs Involving Minors
These are the expectations set forth by Virginia Tech for minors participating in programming associated with Virginia Tech. Any violation of the code of conduct may result in disciplinary action up to and including expulsion from VGSA.

Emergency Information, Releases, and Health History
This form is the student's health history. It will be used in the case of any situation that may require medical attention. Please note, that this form requires the submission of the student’s insurance card and government issued identification (e.g., driver’s license, passport)

Field Trip Permission Form
This form authorizes parental permission for students to participate in VGSA field trips.

Image and Interview Release
This form authorizes the VGSA to use student images or videos including, but not limited to, on social media, print or digital media, and other program promotional materials. 

Medication Form for Minors
This form provides VGSA the appropriate information about student use of prescription and over the counter medications and provides authorization from parents for students to receive prescription or over the counter medication based on the information provided.

Parent/Guardian and Student Acknowledgement Form
This form verifies that both the student and the parents/guardians have reviewed the handbook and the Virginia Tech Acceptable Use of Information Systems website

Permission to Use Student Assignments
This form allows for student assignments completed while attending VGSA to be used for program evaluation, publishing findings from VGSA based on programming, and for improving VGSA. 

Supervision Release Form
This form offers parental consent for the student to be on or off campus unsupervised for short periods of time.

Virginia Tech Principles of Community
This form outlines student expectations for participating in programming on Virginia Tech campus. All Virginia Tech students, faculty, and staff commit to these principles and violation of these principles may result in expulsion from the VGSA. 

Waiver of Liability Form
This form releases the Commonwealth of Virginia, the Virginia Department of Education, and Virginia Polytechnic and State University and their respective agents and employees from liability in the event of harm, accident, or injury.