MDCPS 24 -25 Directory Information Opt-Out Form (Eng.)

Miami-Dade County Public Schools Directory Information Opt-Out Form Miami-Dade County Public Schools (M-DCPS) generally protects a student's personally identifiable information from disclosure without prior consent from parents or eligible students. However, unless the parent or eligible student specifically states in writing that they do not want this information provided, M-DCPS is required to provide senior high school students' names, addresses, and telephone listings to military recruiters or institutions of higher education upon their request.2 Additionally, in a joint effort to increase the number of students applying for higher education financial aid, Miami-Dade County Public Schools and the United States Department of Education (USDOE) are participating in a Free Application for Federal Student Aid (FAFSA) Completion Project. Unless the parent or eligible student specifically states in writing that they do not want student information provided, M-DCPS may provide student information to the USDOE for this purpose.

5-USM/FAFSA 6-IHE/FAFSA 3 FAFSA 7- USM/IHE/FAFSA 4 - USM/IHE

USDOE for FAFSA Completion Project

If you do not want your child's information disclosed to any or all of these entities, check the space next to each entity listed below to which you do not want your child's information disclosed. I DO NOT CONSENT TO DISCLOSURE of my child's name, address, telephone listing, or birth date to the following (check all that apply):

Student's Name*

Date of Birth*

Date

ID#*

I understand that by checking the spaces above and submitting this form to the person indicated below, M-DCPS will restrict the disclosure of personally identifiable student information from my child's educational records to the entities that I have selected.

I further understand that if do not complete and return this form, M-DCPS will release the information to the above- mentioned entities upon request by the entity and has no further obligation to contact me on a case-by-case basis to request my consent for the disclosure of directory information to these entities.

Parent/Guardian Name*

Signature*

Date*

Date

To prohibit disclosure to the above-listed entities, return this form to your child's school within the next 30 days to:

1 The Family Educational Rights and Privacy Act (20 U.S.C. § 1232g; 34 C.F.R., Pt. 99) governs the confidentiality of student educational records. 2 See 20 U.S.C. § 7908. FM-6479E Rev. (01-20)