LEGAL GUARDIAN - SAMPLE LETTER
Date Irvine Valley College 5500 Irvine Center Drive Irvine, CA 92618 Re: (Student Name) I, ______________________ will be the legal guardian of ________________________
Guardian Name Student Name
while he / she attends Irvine Valley College. This student will be living with me and will be placed under my care until he/she reaches the legal adult age of 18 in the United States. I will take full legal responsibility for this student and I authorize the IVC Health Center to administer the Tuberculosis exam for this student.
I live at __________________________________________________
Street Address
________________________________________________________
City State Zip code
Sincerely,
(Signature) Name