506.2E1 - Authorization for Releasing Student Directory Information

The Forest City Community School District has adopted a policy designed to assure parents and students the full implementation, protection and enjoyment of their rights under the Family Educational Rights and Privacy Act of 1974 (FERPA). A copy of the school district's policy is available for review on our website.

This law requires the school district to designate as "directory information" any personally identifiable information taken from a student's educational records prior to making such information available to the public.

The school district has designated the following information as directory information: [Note: a district may, but does not have to, include all the information listed below, which is included in the United States Department of Education's sample policy. This information should match the information contained in 506.1E8 , 506.2R1 , and 506.2E1 ].

• Student's name
• Address
• Telephone listing
• Electronic mail address
• Photograph
• Date and place of birth
• Major field of study
• Dates of attendance
• Grade level
• Participation in officially recognized activities and sports
• Weight and height of members of athletic teams
• Degrees, honors, and awards received
• The most recent educational agency or institution attended
• Student ID number, user ID, or other unique personal identifier used to communicate in electronic systems that cannot be used to access education records without a PIN, password, etc. (A student's SSN, in whole or in part, cannot be used for this purpose.)

You have the right to refuse the designation of any or all of the categories of personally identifiable information as directory information with respect to your student provided that you notify the school district in writing not later than________________________ , 20____ of this school year. If you desire to make such a refusal, please complete and return the slip attached to this notice.

If you have no objection to the use of student information, you do not need to take any action.

NOTE: If the board decides to eliminate name, address or telephone listing from their directory information, military recruiters and postsecondary institutions still have the right, under federal law, to access the three items. If the board eliminates name, address or telephone listing, the district needs to give parents a second notice allowing them to withhold this information from military recruiters or postsecondary institutions.

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RETURN THIS FORM

_____________________________________________________________Community School District Parental Directions to Withhold
Student/Directory Information for Education Purposes, for 20____ - 20____ school year.

Student Name:  _____________________________________________________ Date of Birth:  ______________________
School: ___________________________________________________________  Grade:  ___________________________

(Signature of Parent/Legal Guardian/Custodian of Child) _________________________________________  (Date)  _______

This form must be returned to your child's school no later than _________________________________, 20____ .