Editing previous response:

Please fix the highlighted areas below before submitting.

11th grade students only - Military Information Release

Please complete the form below. Required fields marked with an asterisk *

Each school district is required to notify parents and students of the following information:

When Congress passed the No Child Left Behind Act (NCLB) in 2001, a provision was included that requires high schools to release students’ private information to military recruiters or risk losing federal funding. Under NCLB, public high schools must give military recruiters students’ information unless parents “opt-out” in writing. Recruiters use this information, which includes names, addresses, and phone numbers to individually recruit students through phone calls and in-person visits.

You may opt-out by checking the appropriate box below and returning it to:

BART Charter Public School
One Commercial Street
PO Box 267
Adams, MA 01220

Please select one*

Answer Required

As a parent, I request that you do not turn over the name, address, telephone listing and school records to the Armed Services, Military Recruiters, or Military Schools of the following student.

As a student (18 years or older), I request my own name, address, telephone number, and school records not be released to the Armed Forces, Military Recruiters, or Military Schools.

Student Name*

Answer Required

Parent Signature*

Answer Required