File:  JRA/JRC-E-2 - Opt-Out Form
for Disclosure of Information to Military Recruiters

NOTE: While Colorado school districts are not required by law to adopt an exhibit on this subject, some content in this sample reflects legal requirements school districts must follow. This sample contains the content/language that CASB believes best meets the intent of the law. However, the district should consult with its own legal counsel to determine appropriate language that meets local circumstances and needs.

[ ]  As a parent, I request that my child´s name, address, telephone number and any other directory information not be released to any United States military recruiter.

Signature of parent/guardian_______________________________________

Student´s name__________________________________________________

Date______________________________

[ ] As a student who is 18 years of age or older, I request that my name, address, telephone number and any other directory information not be released to any United States military recruiter.

Signature of student_____________________________________________

Student´s name_________________________________________________

Date____________________________

(Issue date)

[Revised January 2018]

COLORADO SAMPLE EXHIBIT 2007©