Parent or Student:
This is to advise you of your rights with respect to the school records relating to (your son) (your daughter) (you) pursuant to the Federal "Family Educational Rights and Privacy Act of 1974."
Parents of a student under 18, or a student 18 or older, have a right to inspect and review any and all official records, files, and data directly related to their children, including all material that is incorporated into each student's cumulative record folder, and intended for school use or to be available to parties outside the school or school system, and specifically including, but not necessarily limited to, identifying data, academic work completed, level of achievement (grades, standardized achievement test scores), attendance data, scores on standardized intelligence, aptitude, and psychological tests, interest inventory results, health data, family background information, teacher or counselor ratings and observations, and verified reports of serious or recurrent behavior patterns.
A parent of a student under 18 years of age or a student 18 years of age or older shall make a request for access to a child's (their own) school records, in writing, to the Superintendent of Schools. Upon receipt of such request, arrangements shall be made to provide access to such records within a reasonable period of time, but in no case, no more than forty-five (45) days after the request has been received.
Such parents and students are also entitled to an opportunity for a hearing to challenge the content of such records, to insure that they are not inaccurate, misleading, or otherwise in violation of the privacy or other rights of students, and to provide an opportunity for the correction or deletion of any such inaccurate misleading, or otherwise inappropriate data contained therein. Any questions concerning the procedure to be followed in requesting such a hearing should be directed to the Superintendent.
Student records, and any material contained therein which is personally identifiable, are confidential and may not be released or made available to persons other than parents or students without the written consent of such parents or student. There are a number of exceptions to this rule, such as other school employees and officials, and certain State and Federal officials, who have a legitimate educational need for access to such records in the course of their employment.
SUPERINTENDENT OF SCHOOLS
Adoption date: January 1, 1993
NOTIFICATION OF RELEASE OF STUDENT RECORDS PURSUANT
TO COURT ORDER OR SUBPOENA
Parent - Student
The purpose of this notice is to notify you that on _______________(date),
the Phoenix Central School District released the following documents:
from your child's (your own) student records to ____________________________
pursuant to a court order or subpoena, a copy of which is attached hereto.
Signature _________________________________________ Date ____________
APPLICATION TO REVIEW STUDENT RECORDS BY PARTIES
ENTITLED THERETO WITHOUT CONSENT OF PARENT OR STUDENT
have hereby requested access to ________________________________________
______________________________________ records for the following reasons:
Said records will not be made available to any other person or persons
without the specific written consent _____________________________________
___________________________________________________(Parent - Student).
Signature ____________________________________________ Date ________
APPLICATION TO REVIEW STUDENT'S RECORDS AND CONSENT
THERETO BY PARENT OR STUDENT
I, _________________________________________________, authorize
(Name of Student)
(Name or general designation of program making disclosure)
to disclose to _______________________________________________________
(Name of person or organization to which disclosure is to be made)
the following information:
(Nature of the information, as limited as possible)
The purpose of the disclosure authorized herein is to:
(Purpose of disclosure, as specific as possible)
I understand that my records are protected under the federal regulations governing confidentiality of Alcohol and Drug Abuse Patient Records, 42 CPR Part 2, and cannot be disclosed without my written consent unless otherwise provided for in the regulations, I also understand that I may revoke this consent at any time except to the extent that action has been taken in reliance on it, and that in any event this consent expires automatically as follows:
(Specification of the date, event, or condition upon
which this consent expires)
Date: _________________ __________________________________
Signature of Participant
Signature of parent, guardian or
authorized representative when required
Adoption date: January 1, 1993
Reviewed on: February 10, 2004