Request to Opt-Out of School Library Materials Form 11-2022

Request to Opt-Out of School Library Materials Form

Beaufort County School District
THIS FORM IS TO BE COMPLETED BY THE PARENT/LEGAL GUARDIAN MAKING THE REQUEST

Directions: Please complete this form annually online (one per student). Requests will be considered incomplete until this form has been submitted. Please allow 2 school calendar days after submission for processing.
Contact Information of Parent/Legal Guardian Initiating Request
Name*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Mailing Address

Street Address Line 2

City/StateState / Province

Postal / Zip Code
Student's Legal Name*

First NameLast Name
School Location *
Details of Request

You must be the parent or legal guardian of the child forwhich you are making this request.PLEASE SELECT ONE OPTION:
1. Do not allow my child to check out any school library materials from school libraries without my approval of the specific material.2. Do not allow my child to check out specific school library materials. (A list may be attached)3. Do not allow my child to check out any materials from school libraries.
Title of Material: *
Author: *
Publication Year: *
Upload List (optional)

FILE TYPES: pdf, doc, docx, xls, xlsx, jpg, jpeg, png
Cancelof
Signature of parent/guardian*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Request to Opt-Out of School Library Materials Form