JRA-E-2 Denial Of Consent to Release Student Information

DENIAL OF CONSENT TO RELEASE
STUDENT INFORMATION

(For Elementary & Middle Schools)

Federal law and regulations pertaining to family educational rights and privacy allow schools, without prior consent, to release at their discretion information from student educational records that has been designated by the school system as “directory information.” The South Portland School Department has designated the following as directory information: student’s name, participation in officially recognized activities and sports, weight and height of student athletes, grade level in school of participants in extracurricular activities, date of attendance at local school unit schools, and honors and awards received.

(This might include releasing honor roll lists to newspapers identifying student participants in plays, athletics and other performances, etc.)

If you do NOT want the school system to release directory information, please complete the form below and return it to the school.

School Principal

I request that School NOT release information of any kind, including “directory information,” concerning my son/daughter
without my prior written consent.

Parent/Guardian Signature Date

4/4/03