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Mandatory Curriculum Permission Slip


Indiana law (IC 20-19-3-11) requires that all schools provide age appropriate and research based instruction on child abuse and child sexual abuse to students in kindergarten through grade 12. Penn-Harris-Madison has partnered with the Youth Service Bureau to provide this instruction to students in grades six, seven, and eight.


The P-H-M School Corporation will be utilizing information from the Teen Lures Prevention as well as Teen Safety Matters curriculum to educate middle school students on a variety of safety issues.


During the first semester, staff from the Youth Service Bureau of St. Joseph County will present about ways youth can prevent, respond to and report all forms of child abuse, dating violence and sexual assault. By talking openly with students about what constitutes healthy and respectful relationships, we prepare young people to better recognize and resist all forms of mistreatment. The presentations may be given either convocation style or via video, and this school year, we are planning a video presentation for the middle school.


For additional information about the curriculum, please visit

  • and/or
  • MBF Teen Safety Matters - Monique Burr Foundation Monique Burr Foundation.
  • Please find a link here to the video your student will watch if permission is granted.
  • If you have additional questions, please feel free to email Ms. Laurie Ellis, Supervisor of Youth Development Services at Youth Service Bureau at


Please fill out the electronic permission form below to notify us of your wishes for your student(s) to participate in this curriculum. You can sign the form using a mouse or a touch pad screen. A copy of this form will be emailed to you and your student(s) school. *PLEASE NOTE, if you have more than one child in P-H-M, you must fill out a form FOR EACH CHILD. To do it electronically, you need to visit the website for each school your child attends.