506.02-E(1) - Student Directory Information - Authorization for Releasing Student Directory Information

The North Tama County 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 [Insert location here (e.g. online, administrative offices, etc.)]

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.

 

 

 

 

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__ .

Additional forms are available at your child's school.

 

 

Supporting Documents
506_2_E1

 

I.C. Iowa Code References
Iowa Code § 22
Iowa Code § 622.10

I.A.C. Iowa Administrative Code References
281 I.A.C. 12.3 Administration
281 I.A.C. 41 Special Education

U.S.C. - United States Code References Description
20 U.S.C. § 1232g Education - FERPA

C.F.R. - Code of Federal Regulations References
34 C.F.R. Pt. 99 Education - Family Rights and Privacy

Cross References  901  Public Examination of School District Records
                                        902.04 Live Broadcast or Recording

Approved: 9/16/2024
Reviewed: 9/16/2024
Revised: 8/19/2024