REQUEST OF NONPARENT FOR EXAMINATION OR COPIES OF STUDENT RECORDS

The undersigned hereby requests permission to examine the North Linn Community School District's official student records of:

(Legal Name of Student) ________________________________

(Date of Birth)  ________________________________________

The undersigned requests copies of the following official student records of the above student:

----------------------------------------------------------------------

The undersigned certifies that they are (check one):

(a) An official of another school system in which the student intends to enroll. (   )

(b) An authorized representative of the Comptroller General of the United States. (   )

(c) An authorized representative of the Secretary of the U.S. Department of Education (   )

(d) An administrative head of an education agency as defined in Section 408 of the Education Amendments of 1974. (   )

(e) An official of the Iowa Department of Education. (   )

(f) A person connected with the student's application for, or receipt of, financial aid (SPECIFY DETAILS ABOVE.) (   )

The undersigned agrees that no other person will have access to any records or information obtained through this request without the written permission of the parents of the student, or the student if the student is of majority age.

(Signature) _____________________

(Title) _________________________

Date: ______________

Address: _______________________

APROVED:

Signature: _____________________ City:_____________________

Title: __________________State: __________ ZIP ______________

Dated: _______________ Phone Number:______________________

Approved 9/23/11 Reviewed 8/18/2021   Revised

PARENTAL AUTHORIZATION FOR RELEASE OF STUDENT RECORDS

The undersigned hereby authorizes North Linn School District to release copies of the following official student records:

_______________________________________________________________________

Concerning (Full Legal Name of Student) ______________________________________

Date of Birth __________________________________________

Name of Last School Attended   __________________________

Year(s) of Attendance   ____________________________________

The reason for this request is:______________________________________

My relationship to the child is: ______________________________________

Copies of the records to be released are to be furnished to:

(  ) the undersigned

(  ) the student

(  ) other (please specify)

Signature: __________________________

Date: ______________________________

Address: ___________________________

City: ______________________________

State: ________________ ZIP __________

Phone Number: _____________________

Approved 9/23/11 Reviewed 8/18/2021 Revised

REQUEST FOR HEARING ON CORRECTION OF STUDENT RECORDS

To: _______________________________ Address: _________________________

      Board Secretary (Custodian)

I believe certain official student records of my child, ___________________________ (Full Legal Name of Student), _______________________ (School Name), are inaccurate, misleading or in violation of privacy or other rights of my child.

The official education records which I believe are inaccurate, misleading or in violation of the privacy or other rights of my child are:

________________________________________________________________________________

The reason I believe such records are inaccurate, misleading or in violation of the privacy or other rights of my child is: _______________________________________________

My relationship to the child is: ___________________________________

I understand that I will be notified in writing of the time and place of the hearing; that I will be notified in writing of the decision; and I have the right to appeal the decision by so notifying the hearing officer in writing within ten days after my receipt of the decision.

Signature: _______________________________

Date: ___________________________________

Address: ________________________________

City: ___________________________________

State: ________________ ZIP ______________

Phone Number: __________________________

Approved 9/23/11 Reviewed 8/18/2021 Revised

PARENTAL REQUEST FOR EXAMINATION OF STUDENT RECORDS

To: __________________________ Address: ______________________________

Board Secretary (Custodian)

The undersigned desires to examine the following official education records.

____________________________________________________________

of __________________________________ (Full Legal Name of Student)

(Date of Birth) __________ (Grade) ____________

(Name of School) ___________________________

My relationship to the student is:

(check one)

  _____   I do

  _____   I do not

desire a copy of such records. I understand that a reasonable charge will be made for the copies.

Parent's Signature: ______________________________________

APPROVED: _______________________     Date: _____________

Address: _______________________________________________

Signature:____________________________ City: ______________

Title: ________________________________ State: ___________  ZIP _______________

Dated: _______________________________ Phone Number: ______________________

Approved 9/23/11 Reviewed 8/18/2021    Revised ___________

To:                                      Address:                                

    Board Secretary (Custodian)

I believe certain official student records of my child, __________________________________, (Full Legal Name of Student), ________________________ (School Name), are inaccurate, misleading or in violation of privacy or other rights of my child are:

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

The reason I believe such records are inaccurate, misleading or in violation of the privacy or other rights of my child is:

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

My relationship to the child is: ___________________________________

I understand that I will be notifiied in writing of the time and place of the hearing; that I will be notified in writing of the decision; and I have the right to appeal the decision by so notifiing the hearing officer in writing within ten days after my receipt of the decision.

______________________

(Signature)

____________________

(Date)

_____________________________________     ___________________________      ________________     ________________ 

(Address)                                                                (City)                                                    (State)                          (Zip)

_____________________________________

(Phone No.)

Approved 9/23/11     Reviewed   1/18/17             Revised   1/18/17         

NOTIFICATION OF TRANSFER OF STUDENT RECORDS

To: _____________________________    Date: _________________________

         Parent/or Guardian

Street Address: __________________________________________________

City/State:________________________________   ZIP: __________________

Please be notified that copies of the North Linn Community School District's official student records concerning , ________________________________________  (Full Legal Name of Student)

have been transferred to:

School District Name _____________________________ Address __________________________________________

upon the written statement that the student intends to enroll in said school system.

If you desire a copy of such records furnished, please check here  _____  and return this form to the undersigned. A reasonable charge will be made for the copies.

If you believe such records transferred are inaccurate, misleading or otherwise in violation of the privacy or other rights of the student, you have the right to a hearing to challenge the contents of such records.

(Name) _____________________________

(Title) ______________________________

Approved 9/23/11     Reviewed  8/18/2021   Revised

LETTER TO PARENT REGARDING RECEIPT OF A SUBPOENA

Date  _________________________

Dear ( Parent ) _________________ :

This letter is to notify you that the North Linn Community School District has received a (subpoena or court order ) requesting copies of your child's education records.

The specific records requested are

.

The school district has until ( __________________date on subpoena or court order) to deliver the documents to (_____________________ requesting party on subpoena or

court order ) . If you have any questions, please do not hesitate to contact me at (

phone # ______________________) .

Sincerely,

(Principal or Superintendent)

Approved 8/18/2021 Reviewed ___________  Revised ____________

Parents and eligible students will have a right to access a student's education records upon request without unnecessary delay and in no instance more than forty-five calendar days after the request is made. The intent of this regulation is to establish procedures for granting requests from eligible students and parents to access a student's education records.

Education records mean those records that contain information directly related to a student and which are maintained by an education agency or institution or by a party acting for the agency or institution. These may include, but are not necessarily limited to: dates of attendance; academic work completed; level of achievement (grades, standardized 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. Access to Records

a. Parents, eligible students, and other individuals authorized in accordance with law will have access to the student's education records during the regular business hours of the school district.

Parents and eligible students will have a right to access the student's education records upon request without unnecessary delay and in no instance more than forty-five calendar days after the request is made. An eligible student or parent, upon written request to the board secretary, shall receive an explanation and interpretation of the education records. A student, eighteen years or older, has the right to determine who, outside the school system, has access to the records.

Parents of students who are 18 years or older but still dependents for income tax purposes may access the student's records without prior permission of the student.

b. School officials having access to student records are defined as having a legitimate educational interest. A school official is a person employed by the school district as an administrator, supervisor, instructor or support staff member (including health or medical staff and law enforcement unit personnel); a person serving on the school board; a person or company with whom the school district has contracted to perform a special task (such as an attorney, auditor, AEA employee, medical consultant, or therapist); or a parent or student serving on an official committee, such as disciplinary or grievance committee or student assistance team, or assisting another school official in performing his or her tasks.

B. Release of Information Outside the School - Information from education records may be disclosed to outside parties as outlined in board policy and otherwise provided by law.

C. Procedures for Requesting a Record Amendment

a. If the eligible student, parent, or legal guardian believe the information in the education records is inaccurate, misleading, or violates the privacy of the student, the parents or an eligible student may request that the school district amend the education student records.

b. The school district will decide whether to amend the education student records within a reasonable time after receipt of the request.

c. If the school district determines an amendment is made to the education student record, the school district will make the amendment and inform the parents or the eligible student of the decision in writing.

d. If the school district determines that amendment of the student's education record is not appropriate, it will inform the parents or the eligible student of their right to a hearing before the hearing officer provided by the school district. The hearing officer may be an employee of the school district, so long as the employee does not have a direct interest in the outcome of the hearing.

e. Upon parental request, the school district will hold a hearing regarding the content of a student's education records which the parent believes to be inaccurate, misleading, or in violation of the privacy rights of students.

f. The hearing will be held within a reasonable time after receipt of the parent or eligible student's request. The parent or eligible student will receive reasonable advance notice of date, time and place of the hearing.

g. The parents or eligible student will be given a full and fair opportunity to present evidence relevant to the issues. The parent or eligible student may be represented by an individual at their choice at their own expense.

h. The hearing officer will render a written decision within a reasonable period after the hearing. The decision will be based upon evidence presented at the hearing and must include a summary of the evidence and the reasons for the decision.

i. The parents may appeal the hearing officer's decision to the superintendent within [ insert number ] days if the superintendent does not have a direct interest in the outcome of the hearing.

j. The parents may appeal the superintendent's decision or the hearing officer's decision if the superintendent was unable to hear the appeal, to the board within [ insert number ] days. It is within the discretion of the board to hear the appeal.

k. If the parents' and the eligible student's request to amend the education student record is further denied following the hearing, the parents or the eligible student are informed that they have a right to place an explanatory letter in the education student record commenting on the school district's decision or setting forth the reasoning for disagreeing with the school district. Additions to the student's education records will become a part of the education student record and be maintained like other education student records. If the school district discloses the education student records, the explanation by the parents will also be disclosed or the eligible student of the decision in writing.

Approved: 8/18/2021       Reviewed: _____     Revised: _____

The North-Linn Community School District has adopted a policy designed to assure parents and students the full implementation, protection and enjoyment of their rights under the Family Educational Rights and Privacy Act of 1974.  A copy of the school district's policy is available for review in the office of the principal of all of our schools.

This law requires the school district to designate as "directory information" any personally identifiable information taken from a student's educational records prior to making such information available to the public.

The school district has designated the following information as directory information:  student's name, address and telephone number; date and place of birth; major field of study; participation in officially recognized activities and sports; weight and height of members of athletic teams; dates of attendance; degrees and awards received; and the most recent previous educational institution attended by the student and other similar information.  You have the right to refuse the designation of any or all of the categories of personally identifiable information as directory information with respect to your student provided that you notify the school district in writing not later than October 1st of current school year.  If you desire to make such a refusal, please complete and return the slip attached to this notice.

If you have no objection to the use of student information, you do not need to take any action.

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RETURN THIS FORM

                                                     Community School District

Parental Directions to Withhold Student/Directory Information for Education Purposes, for 20   - 20   school year.

Student Name:                                                Date of Birth       

School:                                                      Grade:              

(Signature of Parent/Legal Guardian/Custodian of Child)    (Date) 

This form must be returned to your child's school no later than October 1, 20.  .

Additional forms are available at your child's school.

Approved 9/23/11     Reviewed    8/18/2021            Revised            

The Family Educational Rights and Privacy Act (FERPA), a Federal law, requires that North Linn CSD, with certain exceptions, obtain your written consent prior to the disclosure of personally identifiable information from your child's education records. However, North Linn CSD may disclose appropriately designated "directory information" without written consent, unless you have advised the District to the contrary in accordance with District procedures. The primary purpose of directory information is to allow the North Linn CSD to include this type of information from your child's education records in certain school publications. Examples include:

● A playbill, showing your student's role in a drama production;

● The annual yearbook;

● Honor roll or other recognition lists;

● Graduation programs; and,

● Sports activity sheets, such as for wrestling, showing weight and height of team members.

Directory information, which is information that is generally not considered harmful or an invasion of privacy if released, can also be disclosed to outside organizations without a parent's prior written consent. Outside organizations include, but are not limited to, companies that manufacture class rings or publish yearbooks. In addition, two federal laws require local educational agencies (LEAs) receiving assistance under the Elementary and Secondary Education Act of 1965 (ESEA) to provide military recruiters, upon request, with the following information - names, addresses and telephone listings - unless parents have advised the LEA that they do not want their student's information disclosed without their prior written consent.

If you do not want the North Linn CSD to disclose directory information from your child's education records without your prior written consent, you must notify the District in writing by August 1.

Approved: 8/18/2021    Reviewed: _____   Revised: _____