ACCESS TO STUDENT INFORMATION BY MILITARY COLLEGE RECRUITERS
Name of Student: ________________________________ Date: _________________________
Name of Parent: _________________________________ School: ________________________
Dear Parent/Guardian and Secondary Students:
The Litchfield Public School District receives funds from the federal government under the No Child Left Behind Act of 2001. These funds are used in a variety of ways to provide additional help to students in greatest academic need. The law also requires that districts receiving these funds must, upon request, provide to military recruiters, colleges and universities, access to the names, addresses and telephone listings of secondary students.
It is important for you to know that a secondary school student or his/her parent or guardian may request that the student's name, address, and telephone number not be released by the District without prior written parental consent. If you would like to make such a request, please complete the following and return it to your child's school.
Parent or Guardian: Please complete this section and return the entire form to your child's school. Use a separate form for each child.
I am aware the
Military Recruiters (please check one)
Colleges, Universities, or Institutions of Higher Learning (please check one)
Parent Signature: ____________________________________ Date ____________________
Adult Student Signature: ______________________________ Date ____________________
Litchfield Board of Education
Form adopted: April 19, 2006