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Act to Protect Your Privacy from Military Recruiters

You may be harassed at home by military recruiters because your name, address and phone

number will be given to them by your school — unless you tell your school to not give out the

information. To exercise your legal right to have this information kept private, you should notify our

school office as soon as possible. Some school districts may provide their own forms for this, but

they must obey your request no matter how you submit it. You can write your own letter or use the

one below. Use a letter or form for each individual student and keep a copy. It is not required by

law, but we recommend having a parent or guardian also sign:

Date: _______________________________________________, 2005

Dear administrator

of: ___________________________________________________________________________      

(Name of high school)

We are exercising our right under the No Child Left Behind Act of 2001*, and hereby request that the name, address, and telephone listing of:

(Print name of student)

who is a current student at your school, not be released to military recruiters without prior written parental consent. We do, however, consent to the disclosure of such information to colleges and universities other than military schools.

Print name of parent or legal guardian above________________________________________________________________________

Signature of parent or guardian____________________________________________________

Signature of student_____________________________________________________________

Note to school administrators: Once this request is given to you, it is a serious violation of federal law to disregard it and release the name, address and phone number of this student to any military recruiter without prior written consent. Section 9528(a) of Public Law 107-110 states:

(2) CONSENT-A secondary school student or the parent of the student may request that the student’s name, address, and telephone listing described in paragraph (1) (i.e., the paragraph requiring schools receiving federal aid to release information to military recruiters] not be released

without prior written parental consent, and the local educational agency or private school shall notify parents of the option to make a request and shall comply with any request For more information contact: