Burleson Independent School District 1160 SW Wilshire Blvd ● Burleson, TX 76028

Opt-Out for Student Email Account Burleson Independent School District (BISD) provides an email account through Google for Education to ALL students. The use of the BISD Google mail account is to assist students in completing educational activities as outlined in the Texas Essential Knowledge and Skills (TEKS) and should be used strictly under the rules and regulations that are defined in our district’s “Acceptable Use Policy.” If you DO NOT want your student to have access to a BISD Google mail account, please complete and submit this Opt-Out form to the campus receptionist. This opt-out form for a Google email account applies to the current school year and must be specifically renewed at the beginning of each school year. Student Name:___________________________________________________________________ Campus: _______________________________ School Year: ______________ Grade:_________

Parent/Guardian Name: _______________________________________________________________ (Please Print)

Parent/Guardian Signature:______________________________________ Date: _________________

-------------------------------------------------------- FOR DISTRICT USE -----------------------------------------------------______________ Date this form was forwarded to the Data Services Department. ______________ Date the student’s teachers were notified that the student will not have an email account for instructional purposes. After completion file in the appropriate location.