Troy City Schools FERPA Opt Out Form
The Troy City Schools follows the guidelines of the Family Educational Rights and Privacy Act (FERPA) regarding all student records. The District designates the following personally identifiable information contained in a student’s education records as “directory information:”

1. Name
2. Address
3. Telephone number(s)
4. Date and place of birth
5. Participation of officially recognized activities and sports
6. Achievement awards or honors
7. Weight and height, if a member of an athletic team
8. Major field of study
9. Dates of attendance (‘from and to” dates of enrollment)
10. Date of graduation

“Directory information” is disclosed without prior written consent, except when the request is for a profit-making plan or activity.

Administrative regulations set forth a procedure for annual notification to parents and eligible students of the District’s definition of directory information. Parents or eligible students have two weeks from the start of the school year or their enrollment in which to advise the District in accordance with such regulations of any or all items which they refuse to permit the release of directory information about that student.

This form is to be completed if you refuse to permit directory information regarding your child to be released.

This form applies to the current school year only and must be completed annually.
Student's First Name *
Student's Last Name *
Name of School Student Attends *
Today's Date *
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Electronic Signature - Please enter your full name below. By doing so, you are confirming that you are the legal parent/guardian of the student above and that you do not want directory information released for your student. *
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