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JRA-E2 - Denial of Consent to Release Student Information (Marshwood High School)

(Marshwood High School)

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. MSAD #35 has designated the following as directory information: name, participation and grade level of students in officially recognized activities and sports, height and weight of student athletes, dates of attendance in the school unit, honors and awards received, and photographs and videos relating to student participation in school activities open to the public (except photographs and videos on the Internet).

In addition, the “No Child Left Behind Act of 2001” contains provisions that require that the school unit provide student names, addresses and telephone numbers to military recruiters and institutions of higher learning when requested to do so, unless the student’s parent/guardian or student 18 years of age or older requests in writing that such information not be released. 

If you DO NOT want the information released, please complete the appropriate section of this form and return it to:

Principal, Marshwood High School, 260 Route 236, South Berwick, ME 03908

FOR PARENTS OF STUDENTS UNDER THE AGE OF 18: 

I request that Marshwood High School 

___ NOT release the name, address, or telephone number of my son/daughter ______________________ to any military recruiter or military recruiting organization without my prior written consent.

___ NOT release the name, address, or telephone number of my son/daughter ______________________ to any institution of higher learning without my prior written consent.

___ NOT release information of any kind, including “directory information,” concerning my son/daughter ______________________ without my prior written consent.


____________________________________        __________________

Parent/Guardian Signature                                 Date


FOR STUDENTS 18 YEARS OF AGE OR OLDER:

I request that Marshwood High School

___ NOT release the name, address, or telephone number of my son/daughter ______________________ to any military recruiter or military recruiting organization without my prior written consent.

___ NOT release the name, address, or telephone number of my son/daughter ______________________ to any institution of higher learning without my prior written consent. 

___ NOT release information of any kind, including “directory information,” concerning my son/daughter ______________________ without my prior written consent.


________________________________       ________________

Student Signature                                        Date


Policy revised: February 10, 2021

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