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Military "opt out" Form
Dear Mr. Hults:
Section 9528 of the No Child Left Behind Act of 2001 requires schools to release all Juniors
(11th Grade) and Seniors (12th Grade) Directory information to military recruiters unless we
“opt out” in writing.
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Email
*
Your email
Student Name:
*
Your answer
Parent or Guardian
As a parent, I am exercising the right to request that you do not turn over the name, address, telephone and email listing, and school records to the Armed Services, Military Recruiters, or Military Schools of the following student.
Parent Signature
Your answer
Student
As a student, I request my own name, address, telephone number and school records not be released to the Armed Forces, Military Recruiters, or Military Schools.
Student Signature
Your answer
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