Military and Directory Information Opt-Out Form 2024-2025

Military and Directory Information Opt-Out Form 2025-2026

For students in grades 10, 11 and 12 only
This form provides parents and students the opportunity to opt-out of the release of information to military recruiters and directory information to colleges and other higher education recruiters. If you do not want Newark Charter School to release this information for either of these areas please fill out the form below and return it to your child’s school by October 1, 2025. This is OPTIONAL; only return the form if you wish to opt out of one of these areas. This opt-out is only valid for the current school year; a new form must be submitted each year.
Student Grade*
Student Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
Date
Military Opt-Out

The federal No Child Left Behind Act requires high schools to provide to military recruiters, upon request, the names, addresses and phone numbers of high school juniors and seniors. If you do not want Newark Charter School to release this information without your prior written consent, you must sign below and return this form. If you do not sign below we are required to release student information as requested. A list of guidelines on military recruiters’ access to information can be found at the following website:

http://www.ed.gov/offices/OM/fpco

DO NOT disclose my child’s name, address or telephone number to United State military recruiters without my prior consent.
Parent / Guardian Signature*

Clear
Student Signature (if over 18)

Clear
Colleges & Other Higher Education Opt-Out

The federal No Child Left Behind Act requires high schools to provide colleges and other higher education recruiters, upon request, the names, addresses and phone numbers of high school juniors and seniors. If you do not want Newark Charter School to release this information without your prior consent, you must sign below and return this form. If you do not sign below, we are required to release student information as requested. A list of guidelines on colleges’ access to information can be found at the following website:

http://www.ed.gov/offices/OM/fpco

DO NOT disclose my child’s name, address or telephone number to colleges & other higher education recruiters without my prior
consent.
Parent / Guardian Signature

Clear
Student Signature (if over 18)

Clear
Should be Empty:

Military and Directory Information Opt-Out Form 2025-2026