FL(EXHIBIT) - STUDENT RECORDS

Exhibit A—Consent to Disclose Student Information Protected by the Family Educational Rights and Privacy Act (FERPA)

An "eligible student" is a student who is age 18 or older. A "parent" means a parent of a student and includes a natural parent, a guardian, or an individual acting as a parent in the absence of a parent or a guardian, including a person standing in parental relation to a child. However, a parent does not include a person whose parent-child relationship has been terminated or a person not entitled to possession of or access to a child under a court order.

To ______________________School District:

I hereby agree to allow _____________________________ School District to disclose the following education records or personally identifiable information on those records of ___________________________ (name of student whose information is requested to be disclosed), assigned ID number _________________ (student identification number):

This information may be disclosed for the following purposes:

The above information may be released to the following recipient(s) (name of person, school, agent, or other, including mailing address or contact information for disclosure):

I understand that I may withdraw my consent to share this information at any time. A request to withdraw consent should be signed, dated, and submitted in writing to the campus principal.

Print or type name of parent (or eligible student if age 18 or older):
Signature:
Date:

Exhibit B—Notice of Intent to Comply with Subpoena/Court Order

Date:
To parents/guardians of:
Parent/guardian email address:
Campus name:
Grade level:

Dear parent/guardian:

Enclosed please find a copy of a subpoena or court order, which was received on ______________, 20___. The subpoena or court order requires one or more of the following actions by the date noted on the attached subpoena or court order:

• The disclosure of student information/records of _______________________________ (name of student); and/or
• The testimony (under oath) of a District employee in the above-noted case. During the testimony, the employee under subpoena may be required to disclose information concerning the student, including information from his or her educational record.

The District is required by law to comply with lawfully issued subpoenas and with court orders. According to the Family Educational Rights and Privacy Act, the District is required to notify a parent in advance that the District intends to comply with the subpoena or court order. If you have no objections to the District's compliance with the subpoena or court order, no further action is necessary. If you have such objections to the District's release of information in compliance with the subpoena or court order, please consult your attorney or take whatever steps you deem necessary with the issuing party, agency, or court.

The District will comply as directed by the subpoena or as provided by law unless the parent provides a copy of, or confirmation of, the filing of your objection, if any, with the court. To prevent the District from disclosing information or records the parent deems objectionable, a new court order prohibiting the disclosure or describing in detail the information not to be disclosed must be received by the administrator noted below prior to the deadline in the attached subpoena or court order.

Sincerely,

, Principal/Administrator

Enclosure/attachment

Exhibit C—Release Form for Display of StudentWork and Personal Information

Occasionally, the District wishes to display or publish original student work to promote student academic and extracurricular activities on the District's website; on a website affiliated with or sponsored by the District, such as a campus or classroom website; or in District publications. Original student work includes artwork, projects, photos taken by the student, other academic or creative work, or original video and voice recordings.

Such work may constitute student intellectual property or work subject to copyright and may also include personally identifiable student information as defined by law or by the District.

The District agrees to use these student works and related personally identifiable student information only in the manner described above.

Parent or eligible student (age 18 or older):

I, parent of ___________________________ (student's name), give my permission for the following to be displayed or published by the District:

Or

I, _______________________________ (name of eligible student if 18 or older), give my permission for the following to be displayed or published by the District:

(Check all that apply.)

• Original student work, e.g., artwork, projects, photos taken by the student, or other academic or creative work
• Voice recordings
• Video recordings

I also consent for the District to publish the following identifiable student information with the work: (list any personally identifiable student information that will be published with the work):

• Student name
• Student age
• Student grade level
• (list any other information that will be published or displayed)

Signature of parent or eligible student:
Date:

Exhibit D— Disclosure of Student Information Protected by FERPA to Parents of Dependent Students 18 Years or Older

Date:
To: (ISD)
From: (full name of parent requesting information)
Address: (full address with city, state, and zip code)
Student's full name:
Campus:
Grade level:

Under the Family Educational Rights and Privacy Act (FERPA), the ________________ School District is permitted to disclose information from education records to a parent if the parent claims the student as a dependent for federal tax purposes. Please indicate whether you are a parent of the student whose records or information you seek and whether you claim the student as a tax dependent.

Please check applicable boxes to affirm:

• I certify that I am a parent of ________________________________ (name of student) as defined above.
• I certify that I claim ___________________________________ (name of student) as a dependent for federal income tax purposes at the time this request is made.

Signature of parent:
Date:

Azle ISD

FL(EXHIBIT)-X

LDU 2021.03

DATE ISSUED: 7/1/2021