Student Information Opt-Out Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Two federal laws require local educational agencies (LEAs) receiving assistance under the Elementary and Secondary Education Act of 1965 (ESEA) to provide military recruiters, upon request, with three directory information categories names, addresses and telephone listings unless parents have advised the LEA that they do not want their student's information disclosed without their prior written consent. (These laws are: Section 9528 of the ESEA (20 U.S.C. 7908), as amended by the No Child Left Behind Act of 2001 (P.L. 107-110), the education bill, and 10 U.S.C. 503, as amended by section 544, the National Defense Authorization Act for Fiscal Year 2002 (P.L. 107-107), the legislation that provides funding for the Nation's armed forces.)

If you do not wish us to provide your student's information to military recruiters, please fill out the form below.

Your Student's Name *

Student's Grade

Student's ID Number

By typing your name below, you are certifying that you are the parent/guardian of the student listed above and that you do not want your student's information shared with military recruiters. *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of The Palmdale Aerospace Academy. Report Abuse

Forms