To: All parents |
School Year _____________
|
[Listed below are example of Directory Information]
Please consider very carefully your decision
to withhold any item of "directory information." Should you decide to inform
[name of agency or school] not to release any or all of the items listed
below, any future requests for such information from individuals or entities
not affiliated with the [name of agency or school] will be refused. Please
indicat here your request to withhold any or all of the above items:
If this form is not received in [name of
office] prior to [date], it will be assumed that the above information
may be released for the remainder of the current school year. A new form
for nonrelease must be completed each [term/semester/year].
Parent's Name:
_________________________ |
Student's Name:
______________________________ |
Signature: __________________________ | Date: ________________ |
For questions about the content of this product, please contact
Lee
M. Hoffman.