[Note: This notice may be given separately or included with the Public Notice in Policy 515.]

PUBLIC NOTICE

	Independent School District No. ___ gives notice to parents of students currently in attendance in the school district, eligible students currently in attendance in the school district, and students currently in attendance in the school district of their rights regarding the conduct of surveys, collection and use of information for marketing purposes, and certain physical examinations.

1. 	Parents, eligible students, and students are hereby informed that they have the following rights:

		a.	All instructional materials, including teacher’s manuals, films, tapes, or other supplementary material which will be used in connection with any survey, analysis, or evaluation as part of any program funded in whole or in part by the U.S. Department of Education, shall be available for inspection by parents or guardians of students.

		b.	No student shall be required, as part of any program funded in whole or in part by the U.S. Department of Education, without the prior consent of the student (if the student is an adult or emancipated minor), or in the case of an unemancipated minor, without the prior written consent of the parent, to submit to a survey that reveals information concerning:

			(1)	political affiliations or beliefs of the student or the student’s parent;

			(2)	mental and psychological problems of the student or the student’s family;

			(3)	sex behavior or attitudes;

			(4)	illegal, antisocial, self-incriminating, or demeaning behavior;

			(5)	critical appraisals of other individuals with whom respondents have close family relationships;

			(6)	legally recognized privileged or analogous relationships, such as those of lawyers, physicians, and ministers;

			(7)	religious practices, affiliations, or beliefs of the student or the student’s parent; or

			(8)	income (other than that required by law to determine eligibility for participation in a program or for receiving financial assistance under such program).

		c.	A parent, on behalf of a student or an eligible student, has the right to receive notice and an opportunity to opt the student out of participating in:

			(1)	Activities involving the collection, disclosure, or use of personal information collected from students for the purpose of marketing or for selling that information, or otherwise providing that information to others for that purpose.

			(2)	The administration of any third-party survey (non-Department of Education funded) containing one or more of the items contained in Paragraph 1.b., above.

			(3)	Any nonemergency, invasive physical examination or screening that is required as a condition of attendance, administered by the school or its agent, and not necessary to protect the immediate health and safety of a student, except for hearing, vision, or scoliosis screenings, or any physical examination or screening permitted or required under state law.

		d.	This notice does not preempt applicable state law that may require parental notification.

		e.	The school district has developed and adopted a policy, in consultation with parents, regarding these rights, as well as arrangements to protect student privacy in the administration of protected surveys and the collection, disclosure, or use of personal information for marketing, sales, or other distribution purposes.

		f.	The school district will directly notify parents and eligible students of these policies at least annually at the start of each school year and after any substantive changes.

		g.	The school district will directly notify parents and eligible students, at least annually at the start of each school year or, if scheduled thereafter, parents will be provided with reasonable notice of the specific or approximate dates of the following activities and provide an opportunity to opt a student out of participating in:

(1)	Collection, disclosure, or use of personal information for marketing, sales, or other distribution.

(2)	Administration of any protected information survey not funded in whole or in part by the U.S. Department of Education.

(3)	Any nonemergency, invasive physical examination or screening as described above.

				[See consent/opt-out for specific activities attached hereto.]

Parents/eligible students who believe their rights have been violated may file a complaint with:

				Family Policy Compliance Office
				U.S. Department of Education
				400 Maryland Avenue SW
				Washington, DC  20202-5920

						INDEPENDENT SCHOOL DISTRICT NO. ___
						___________________________, MINNESOTA

Dated:_____________________		___________________________________
						Chair

PPRA NOTICE AND CONSENT/OPT-OUT FOR SPECIFIC ACTIVITIES

The Protection of Pupil Rights Amendment (PPRA), 20 U.S.C. § 1232h, requires [name of school district or school] to notify you and obtain consent or allow you to opt your child out of participating in certain school activities.  These activities include a student survey, analysis, or evaluation that concerns one or more of the following eight areas (“protected information surveys”):

	1.	Political affiliations or beliefs of the student or the student’s parent;
	2.	Mental and psychological problems of the student or the student’s family;
	3.	Sex behavior or attitudes;
	4.	Illegal, antisocial, self-incriminating, or demeaning behavior;
	5.	Critical appraisals of other individuals with whom respondents have close family relationships;
	6.	Legally recognized privileged or analogous relationships, such as those of lawyers, physicians, and ministers;
	7.	Religious practices, affiliations, or beliefs of the student or the student’s parent; or
	8.	Income, other than as required by law to determine program eligibility.

This requirement also applies to the collection, disclosure, or use of student information for marketing purposes (“marketing surveys”) and certain physical examinations and screenings.

Following is a schedule of activities requiring parental notification and consent or opt-out for the upcoming school year.  (Please note that this notice and consent/opt-out transfers from parents to any student who is 18 or older or an emancipated minor under state law.
												
Date:
Grades:  [see sample activity notices attached]
Activity:
Summary:

Consent or Opt-out: [or both depending on situation]

If you wish to review any survey instrument or instructional material used in connection with any protected information or marketing survey, please submit a request to [school official, address].  [School official] will notify you of the time and place where you may review these materials.  You have the right to review a survey and/or instructional materials before the survey is administered to a student.

I      [parent’s name]      give my consent for      [child’s name]      to take      [survey]      on
     [date]     .
						____________________________
						Parent’s signature

Please return this form no later than    [insert date]    to [name of school official and mailing address].

EXAMPLES OF ACTIVITIES

Date:		On or about October 15, 2010
Grades:	Five and Six
Activity:	ABC Survey of At-Risk Behaviors
Summary:	This is an anonymous survey that asks students questions about behaviors such as drug and alcohol use, sexual conduct, violence, and other at-risk behaviors.  The survey also asks questions of a demographic nature concerning family make-up, the relationship between parent and children, and use of alcohol and drugs at home.

Consent [for U.S. Department of Education funded, protected information surveys only]:  A parent must sign and return the attached consent form no later than [insert return date] so that your child may participate in this survey.

Opt-out [for any non-U.S. Department of Education funded protected information survey]:  Contact [school official] at [telephone number, email, address, etc.] no later than [date] if you do not want your child to participate in this activity.

Date:		November 22-24, 2010
Grades:	One through Six
Activity:	Flu Shots
Summary:	The County Department of Public Health Services will administer flu shots for influenza types A and B.

Opt-out:	Contact [school official] at [telephone number, email, address, etc.] no later than [date] if you do not want your child to participate in this activity.

Below is an example dealing with the collection, use, and distribution of personal information for student-based commercial services.

[Limited to personal information designated as “directory information”]

Date:		2010-2011 School Year
Grades:	Nine through Twelve
Activity:	Student-Based Commercial Services
Summary:	[School] collects, or allows businesses to collect, use, and disclose personal information on students, including names, addresses, and telephone listings.  These businesses provide student-based products and services, such as computer equipment, sports clothing, school jewelry, and entertainment products.

Opt-out:	Contact [school official] at [telephone number, email, address, etc.] no later than [date] if you do not want your child to participate in this activity.

[Note:  This information – names, addresses, and telephone listings – may be designated and disclosed as “directory information” under the school district’s student records policy.  Instead of using this Model Notice format, schools may meet PPRA notice requirements for specific marketing activities that involve only designated “directory information” by allowing parents to opt out of “directory information” at the start of each school year, which would include all marketing activities.]