Each school district shall develop a form which evidences parental consent for exemption from further compulsory school attendance pursuant to Education Code Section 48410(e). The form shall be made available upon request to 16 and 17-year-old pupils who have demonstrated proficiency. The form shall contain at least the following information:
(a) A general explanation of the pupil's rights of exemption from compulsory school attendance and of re-enrollment in the public high schools.
(b) The date of issuance of a certificate of proficiency.
(c) The signature of the parent and the date.
(d) The signature of a school administrator who has personally confirmed the authenticity of the parent's signature and the date.
(Amended by Register 78, No. 29.)