Directory Data Forms | lakeholcombe-ar.rschooltoday.com

Directory Data

The information on Student RecordsAIirectory Data is found in Policy 346.3 of the Parendstudent Handbook. It states the rights of parents/guardians or adult students under the policy stated above. The rights alluded to are:

1. To inspect and review the student's educational record.

2. To seek amendment of the student's educational records that the parent/guardian or adult student believes to be inaccurate, misleading or otherwise in violation of the student's privacy act.

3. To consent to disclosures of personally identifiable information contained in the student's educational record.

The School Board of Lake Holcombe has designated the following as Directory Data: student name, address, parent/guardian name, date and place of birth, participation in officially recognized activities and sports, weight, height, dates of attendance, photographic and electronic images, awards and the name of the school most recently attended.

It also should be understood that the school district is required to provide on request made by military recruiters or institutions of higher education, access to secondary school students; names, addresses and telephone listings unless such information has been restricted by the secondary school student or the parent/guardian as outlined above.

If you as a parent/guardian do not wish to have any of these items named as Directory Data for your child, you have 14 days to inform the school. If the school does not receive the following request with 14 days, the school has the ability to release the above stated information.

If you do not want any of the information listed below to be released by the school, please check off the appropriate areas. Send this form back to the school no later than 14 days after school has started

_______________________________________________________________________________________________________

I do not want the following information about my child released by the school.

Name

Address

Weight

Height

Date of Birth

Place of Birth

Parent/Guardian Name

Last School Attended

Dates of Attendance

Participation in officially recognized activities and sport

Awards

Photographic and Electronic Images (by checking this option your child's picture will be excluded from the yearbook, memory book, newspaper, TV, and school website)

All of the Above

Student's Full Name:

Grade: *

Parent/Guardian's Electronic Signature: *

Date: *

Month

Day

Year

Address: *

City: *

State: *

Zip Code: *

Home Phone: *

Work Phone: *

Cell Phone: *

The School District of Lake Holcombe does not discriminate against pupils on the basis of sex, race, national origin, ancestry,
orientation, or physical, mental, emotional or learning disability or handicap in its education programs or activities. Federal
law prohibits discrimination in employment on the basis of age, race, color, national origin, sex, religion or handicap.

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