FERPA

Fort Mill School District classifies the following student information as directory information: name; address;
telephone number; photograph; date and place of birth; major field of study; dates of attendance; school and grade
level; participation in officially recognized activities and sports; weight and height of members of athletic team(s);
degrees, honors or awards received; the most recent educational agency or institution attended; and
district-assigned student identification number (not Social Security number), user ID, or other unique personal
identifier.

During your child’s school career, your child will participate in a variety of academic, athletic, fine arts and other
events and activities. During these events/activities, your child may be photographed and/or interviewed by the
district or school staff, other students, or news media. Information about your child may appear in newspaper articles,
on television, in radio broadcasts, on displays, on the Internet, or in district and/or school promotional pieces
including, but not limited to, district or school websites, school annuals or yearbooks, brochures, fliers, honor roll or
other recognition lists, newsletters, playbills, programs (including graduation and athletic programs), television
shows, videos, etc.

The district may include directory information in these school, district, or media communication pieces and may
disclose, without prior written consent, directory information to outside organizations without a parent’s prior written
consent unless you have advised the district to the contrary. Outside organizations include, but are not limited to,
companies that manufacture class rings, take school photographs or publish yearbooks.
You may change your mind and revoke or revise this authorization at any time (except when action has already been
taken) by filling out another copy of this form (available on our website at www.fortmillschools.org) and returning it to
your child’s principal.

Please check ONE of the following options. If you do NOT want the district to release some or all of your child’s directory information without prior written consent, you must notify the district in writing by completing this Directory Information Form online in Registration Gateway, the district’s online registration system, or by returning a printed copy of this form to your child’s school by the 15th day of school.

____ OPTION 1 — RELEASE OF ALL INFORMATION
We, the parent(s)/guardian(s) and student or — I, the student (if 18 years of age or older), hereby GRANT Fort Mill School District permission to release all directory information.

____ OPTION 2 — RELEASE OF SOME INFORMATION
We, the parent(s)/guardian(s) and student or — I, the student (if 18 years of age or older), hereby GRANT Fort Mill School District permission to release all directory information EXCEPT for student’s home address and student’s home telephone number. This means that no directory information about this student will be released to military recruiters and the student’s home address and telephone number will not be released to third parties such as companies that manufacture class rings, graduation supplies, or take senior class portraits. I understand that this means my child’s directory information such as student’s picture, student’s name, student’s school and grade level, student’s weight and height if he/she is a member of an athletic team(s), student’s degrees, honors, or awards received could be in the school year book, honor rolls, playbills, graduation and athletic programs, and other publications such as newspapers, television, radio, and media websites.

____ OPTION 3 — RELEASE OF NO INFORMATION
We, the parent(s)/guardian(s) and student or — I, the student (if 18 years of age or older), hereby ask that Fort Mill School District NOT release ANY directory information. This means that no directory information about this student will be released to military recruiters; companies that manufacture class rings, take school photographs or publish yearbooks; newspapers, television, radio, or media websites and that no information will be put in district/school promotional pieces including, but not limited to, district or school websites, school annuals or yearbooks, brochures, fliers, honor roll or other recognition lists, newsletters, playbills, programs (including graduation and athletic programs), television shows, videos, etc. I understand that this means my child’s photograph will not be in the school yearbook, honor rolls, or any other publications.
Student Name (print): ________________________________________
School of Attendance: ________________________________________
Parent/Guardian Name (print): ________________________________________
Parent/Guardian Signature: ________________________________________
Student Signature (if 18 years of age): ________________________________________

Date: ________________________________________