F-1 3250
STUDENTS
Release of Student Directory Information
The following directory information may be released by the district unless a student's parents (or
guardian) request in writing that such information not be released per Kennewick School
District Policy 3250
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The 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
The most recent previous educational agency or institution attended by the student
Photographs and other similar information
At least once a year, parents shall be notified of their right to request that student directory
information not be released without their proper consent.
-----------------------------------------------------------------------------------------------------------Name of Student _________________________________________________________
School Attending _________________________________________________________
[ ] I have read the above and agree my child’s student directory information may be released.
Name of Parent/Guardian __________________________________________________
Signature: __________________________________________ Date:_______________
[ ] I have read the above and request that my child’s student directory information NOT be
released unless my permission is obtained by the Kennewick School District.
Name of Parent/Guardian __________________________________________________
Signature: __________________________________________ Date:_______________
Telephone number: _______________________________________________________
07/09