DPS 109 Directory Information Opt-Out Form
District 109 maintains directory information and shares it with our parent-teacher organizations and other District-connected organizations so that they can keep parents in the loop with important information (such as school lunch ordering, after-school enrichment, and other events, volunteer opportunities, and educational trips for middle school students). If you wish to opt-out of sharing directory information, per Board Policy 7:340, you must submit, in writing, a signed statement that you do not grant any publication permissions to District 109. You only need to opt-out of directory information one time (not every year).
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Email *
Name of student: *
School/program they attend: *
Grade level for the 2022-2023 school year: *
Name of parent/guardian completing form: *
Today's Date: *
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