Skip To Main Content

506.2E1 Authorization for Releasing

The Lewis Central 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 online or at the Educational Resource Center.

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:

  • 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.


Community School District Parental Directions to Withhold Student/Directory Information for Education Purposes, for 20 - 20 school year.

Student Name:

Date of Birth



(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.

  • Series 500 Students