506.02E1 - Authorization for Releasing Student Directory Information

The Bennett 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 in the administrative offices at 300 Cedar St, Bennett IA  52721.

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:

•   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 September 1 of the current 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.

 

 

 

 

RETURN THIS FORM

Bennett 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_______.

Additional forms are available at your child’s school.