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Manhasset Public Schools
5000 - STUDENTS
5500E4 SAMPLE NOTIFICATION- DISCLOSURE TO THE MILITARY
Last Updated Date: 10/22/2020
Revisions History: 10/22/2020
Related Policies & Documents: 5500, 5500R, 5500E1, 5500E2, 5500E3
Dear Parent/Guardian
or Eligible Student:
Pursuant to the No Child Left Behind Act, the District must disclose to military recruiters and institutions of higher learning, upon request, the names, addresses and telephone numbers of high school students. The District must also notify parents/guardians of their right, and the right of their child, to request that the District not release such information without prior written parental/guardian consent.
Parents/guardians (or students 18 years of age or older) wishing to exercise their option to withhold their consent to the release of the above information to military recruiters and/or institutions of higher learning must sign and return the attached form to the Building Principal by {Insert Date of Return Here}
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
SAMPLE RETURN FORM
Reservation of Consent for the Release of Certain Student Information under the No Child Left Behind Act
_____ Please do not release the name, address and telephone number of
____________________________________________________________ to:
(Name of student)
_____ Military recruiters and/or
_____ Institutions of higher learning
(Parent/Guardian or Eligible Student Signature) (Date)
Policy References