GRAND BLANC COMMUNITY SCHOOLS DENIAL OF PERMISSION TO RELEASE CERTAIN DIRECTORY INFORMATION WITHOUT PRIOR WRITTEN CONSENT I deny permission for the Grand Blanc Community Schools (the “District”) to release certain directory information concerning my child(ren)/ward(s) as follows: I. Name(s) of Child(ren)/Ward(s): ______________________________

______________________________

______________________________

______________________________

______________________________

______________________________

II. Information NOT to be released (check items not to be released): _____ 1. _____ 2. _____ 3. _____ 4. _____ 5. _____ 6. _____ 7. _____ 8. _____ 9. _____ 10. _____ 11. _____ 12. _____ 13.

Student’s name Home address Telephone listing Electronic mail address Grade level Photograph Date and Place of birth Major field of study Dates of attendance Participation in officially recognized activities and sports Weight and height of members of athletic teams Degrees, honors and awards received The most recent educational agency or institution attended

Signature of parent/guardian: ________________________________________ Date: _________________

FERPA Denial of Permission to Release Student Records.pdf ...

Page 1 of 1. GRAND BLANC COMMUNITY SCHOOLS. DENIAL OF PERMISSION TO RELEASE CERTAIN DIRECTORY INFORMATION. WITHOUT PRIOR WRITTEN CONSENT. I deny permission for the Grand Blanc Community Schools (the “District”) to release. certain directory information concerning my ...

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