Forms & Notifications



    Dear Parent and Student:

    The Family Educational Rights and Privacy Act (FERPA) (20 USC § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the US Department of Education.

    1. You have a right to look at your school records. To look at your records you should give the principal a written request listing the records that you want to see. The principal must allow you to see the records within 30 days from receiving your request.

    2. You have a right to request changes in your school records if you believe the records are inaccurate, misleading, or that they violate your privacy rights. If you want to change your records you should tell the principal in writing what you want changed and why you think it ought to be changed. If the principal agrees with you, your records will be changed. If the principal disagrees with you, you may request a hearing. More information regarding this process can be found in Policy 8330, located on the District’s website.

    3. Your consent is required before others may see your school records; however the law authorizes some people to see your records without your consent. One example is a school official with a legitimate educational interest in the record. A school official includes a person employed by the School Board as an administrator, attorney, supervisor, instructor, or support staff member; adult school volunteer; and a person or company with whom the School Board has contracted to perform a special task (such as an attorney, school resource officer, auditor, medical consultant, or therapist). A school official has a legitimate educational interest if the official needs to review an education record in order to fulfill his or her professional responsibility.

    4. You have a right to file a complaint with the U.S. Department of Education if you believe the school has violated any of your rights with respect to school records. If you have a complaint, send it in writing to:

    Student Privacy Policy Office
    U.S. Department of Education
    400 Maryland Avenue, S.W.
    Washington, D.C. 20202-4605

    Some of the information in your school records is not confidential and may be released without your consent. This information is known as “directory information.”

    If you do not want directory information released, you must tell the principal in writing what types of directory information you do not want released. That written notice to the principal must be received no later than September 1 of each year or within 20 days of receiving this annual notice. You may use the form on page 17 to do this (Part 1).

    Military recruiters and institutions of higher education are entitled under federal law to a list of names, addresses, and telephone numbers of high school students unless you object to such release. If you notify your principal in writing at any time that you do not wish your child’s name, address, and telephone number released without your written consent, we will honor that request. You may use the form on page 17 to do this (Part 2).

    Both parents have a right to see the school records of their child unless there is a certified copy of a court order on file at the school that specifically denies the right to access to school records.

    Copies of school records are available for a minimal copying charge. If you have any questions about these rights, please contact your school office.



    The Pledge of Allegiance to the American Flag shall be rendered daily. Those students not wishing to participate should maintain a respectful silence, refraining from any act that would interfere with such observance. See School Board Policy 8810.



    The Protection of Pupil Rights Amendment (PPRA) requires the Pinellas County School District to notify you concerning the following School Board policy. The policy requires the district to obtain consent or allow you to opt your child out of participating in surveys.

    Policy 2416 Student Survey Administration

    The purpose of this policy is to comply with the Federal law for the collection and reporting of certain information by means of student surveys. The information that will be collected relates to student attitudes and behaviors on topics such as school safety, substance use and the prevalence of risky attitudes or behaviors, particularly with respect to alcohol and drug abuse. In addition, these surveys also collect information on general health practices and human sexuality. Such information is collected anonymously, and no personally identifiable information is obtained from or reported on any individual student. The District cooperates with other agencies such as the Florida Department of Health in conducting these surveys.

    All student surveys must be approved by the Department of Assessment, Accountability, and Research.

    Parents will be notified of upcoming surveys that reveal information concerning one (1) or more of the following items:

    A. political affiliations or beliefs of the student or the student’s parent;

    B. mental and psychological problems of the student or the student’s family;

    C. sexual behavior or attitudes;

    D. illegal, anti-social, self-incriminating, or demeaning behavior;

    E. critical appraisals of other individuals with whom respondents have close family relationships;

    F. legally recognized privileged or analogous relationships, such as those of lawyers, physicians, and ministers;

    G. religious practices, affiliations, or beliefs of the student or student’s parent;

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

    Participation Voluntary

    No student shall be required to participate in such a survey if the student or the student’s parent, if the student is less than eighteen (18) years of age, objects to participation.

    Right to Inspect

    A student or the student’s parent, if the student is less than eighteen (18) years of age, has the right to inspect any such survey instrument before the survey is administered or distributed to students if a request is made within a reasonable period of time. Parents also have the right to be advised of arrangements that will be made to protect student privacy.

    Student survey instruments and teacher directions for administering the survey will be available at each participating school within a reasonable period of time prior to the survey administration.

    Parents have the right to inspect, upon request, any instructional material used as part of the educational curriculum of the student or used in a research or experimentation program in which the student is engaged. The parent will have access to the instructional material within a reasonable period of time after the request is received by the building principal.

    Notification of Parents

    Parents will be notified of this policy annually at the beginning of the school year and within a reasonable period of time if any substantive change is made to this policy. Such notice shall include the specific or approximate dates during the school year when any such survey will be administered.

    F.S. 1000.21(5), 1001.32(2), 1001.41, 1001.42, 1001.43, 1002.22

    20 U.S.C. 1232g

    Statement on the Collection, Use or Release of Social Security Numbers of Students and/or Parents***

    Please Read the Information below.

    The School Board of Pinellas County is authorized to collect, use or release social security numbers (SSN) of students and/or parents*** for the following purposes, which are noted as either required or authorized by law to be collected. The collection of social security numbers is either specifically authorized by law or imperative for the performance of the District’s duties and responsibilities as prescribed by law [Fla. Stat. §119.071 (5) (a) 2 & 3].

    1. Student registration and student identification numbers. [Required to request by Fla. Stat. §1008.386 and Fla. Stat. § 119.071 (5) (a) 6.1008.386 notes as an exception: “However, a student is not required to provide their social security number as a condition for enrollment or graduation.”]

    2. Registration in an adult education program [Required by Fla. Admin. Code 6A-10.0381, if available and/or student identifier, as required by Fla. Stat. § 119.071 (5) (a) 6.]

    3. Tracking of adult students enrolled in a postsecondary program. [Required by Fla. Admin. Code 6A-1.0955(3) (e), and by Fla. Stat. §119.071 (5) (a) 6J

    4. Criminal history. Level 1 and level 2 background checks / Identifiers for processing fingerprints by Department of Law Enforcement/ Registration information regarding sexual predators and sexual offenders authorized by Fla. Stat. § 943.04351, if SSN is available. [Required by Fla. Admin. Code 11 C-6.003 and Fla. Stat. § 119.071 (5) (a)2 6]

    5. Reports on students required to be submitted to Florida DOE [Authorized by Fla. Stat. § 119.071 (5) (a) 2& 6]

    6. Tort claims and tort notices of claim against the School Board [Required by Fla. Stat. § 768.28 (6), and Fla. Stat. § 119.071 (5) (a) 6]

    7. Use of motor vehicle information from the Department of Motor Vehicles for the District to carry out its functions and to verify the accuracy of information submitted by agent or employee to District, including to prevent fraud, in connection with insurance investigations, and to verify a commercial driver’s license. [Authorized by federal law 18 U.S.C. 2721 et seq. and Fla. Stat. §119.071(5) (a) 6]

    8. Information received from DOE to locate missing Florida School Children. {Required by Fla. Admin. Code 6A-6.083 and Fla. Stat. §119.071 (5) (a) 6]

    9. National School Lunch Act application verification process /Eligibility for Free and Reduced Price Meals and Free Milk in Schools. [Required of the adult, if the person has a number, by federal law 42 U.S.C. 1751 et seq. and federal regulations 7 C.F.R. 245.2 and .3 and Fla. Stat. § 119.071 (5)(a)6]

    10. Reports from Department of Motor Vehicles of each student whose driver’s license is suspended for excessive unexcused absences and reports to Department of non-enrollment or non-attendance upon the part of a student who is required to attend some school. [Required by Fla. Stat. §322.091 (5) and §1003.27 and Fla. Stat. § 119.071 (5)(a)6]

    11. Written verification from employer for vocational education, student follow up. [Required by Fla. Admin. Code 6A-10.0341 and Fla. Stat. § 119.071 (5) (a) 6]

    12. Child abuse report to DCF, of student victim and subjects of report. [Required by Fla. Admin. Code 65C-29.002 and Fla. Stat. § 119.071(5) (a) 6]

    13. Identification of blood donors [Authorized by 42 U.S.C. 405 (c) (2) (D) (i)]

    14. The disclosure of the social security number is expressly required by federal or state law or a court order. [Required by Fla. Stat. §119.071(5) (a) 6.]

    15. Collection and/ or disclosure are imperative or necessary for the performance of the District’s duties and responsibilities as prescribed by law, including but not limited for password identification to the District’s network. [Authorized by Fla. Stat. §119.071 (5) (a) 6 and required by Fla. Stat. § 119.071 (5) (a) 2]

    16. The individual expressly consents in writing to the disclosure of their social security number. [Authorized by Fla. Stat. §119.071 (5) (a) 6]

    17. The disclosure of the social security number is made to prevent and combat terrorism to comply with the USA Patriot Act of 2001, Pub. L. No. 107-56, or Presidential Executive Order 13224. [Required by Fla. Stat. § 119.071 (5) (a) 6]

    18. The disclosure of the social security number is made to a commercial entity for the permissible uses set forth in the federal Driver’s Privacy Protection Act of 1994,18 U.S.C. Sec. 2721 et seq.; the Fair Credit Reporting Act, 15 U.S.C. Sec. 1681 et seq.; or the Financial Services Modernization Act of 1999, 15 U.S.C. Sec. 6801 et seq., provided that the authorized commercial entity complies with the requirements of this paragraph 5 in Fla. Stat. § 119.071. [Authorized by Fla. Stat. §119.071 (5)(a)6J

    19. Income for Medicaid eligibility, determine the amount of medical assistance payments, process Medicaid billing, and provide program follow-up [Required by federal regulation 42 C.F.R. § 435.910, unless student applicant for Medicaid refuses to obtain a social security number, based on well-established religious objections]

    *** Note, this statement states the reasons for collecting, using or releasing the social security numbers only of students and/or parents. Separate statements set forth the reasons for collecting, using or releasing the social security numbers of employees and volunteers.


    PINELLAS COUNTY SCHOOLS School And Classroom Library Material Student Access Form

    To the parents of:

    School: Date:

    The purpose of this form is for families to communicate their preference regarding a student’s access to school and classroom library materials.

    To view current school and classroom library materials that students have access to, please visit Library Media Materials Search.

    Please select one of the following:

    I allow my student access to school and classroom library materials.

    I wish to limit my student’s access to school and classroom library materials. For this option, please contact your student’s school. Limitations will not be put in place until they have been communicated directly to the school.

    For additional information about our district school and classroom library selection process, please see Library Media Materials Selection Guidelines.

    For additional information about our objection process, please see Policy 2510 – Instructional Materials, Including Textbooks.



    The annual school report for 2022-2023, including the average amount of money expended per student in each school, is available at your child’s school and the on district website at the following link, Please contact your school to obtain a copy or visit the website if you would like to review the report.



    Following is the Florida law which allows minors, 17 years old, to donate blood without parental consent. Parents who object must notify the school in writing.

    Florida Statute 743.06. Removal of disabilities of minors; donation of blood without parental consent. – Any minor who has reached the age of 17 years may give consent to the donation, without compensation therefor, of her or his blood and to the penetration of tissue which is necessary to accomplish such donation. Such consent shall not be subject to disaffirmance because of minority, unless the parent or parents of such minor specifically object, in writing, to the donation or penetration of the skin.



    Pursuant to Florida State Board of Education Rule, the District is hereby notifying parents and guardians that they are responsible to:

    1. Ensure the safe travel of their students during the portions of each trip to and from school and home when the students
    are not under the custody and control of the District, including during each trip to and from home and the assigned bus
    stop when the District provides bus transportation;

    2. Ensure that students ride only in their assigned school buses and get off only at assigned bus stops, except when the District has approved alternative buses or arrangements;

    3. Ensure students are aware of and follow the District’s adopted Code of Student Conduct while the students are at school bus stops and to provide necessary supervision during times when the bus is not present; and

    4. Ensure that, when the physical disability of the student renders the student unable to get on and off the bus without assistance, the parent or guardian provides the necessary assistance to help the student get on and off at the bus stop,
    as required by District policy or the student’s individual educational plan.



    This CODE has been written so students and family members know what behavior is expected and prohibited at school or at school activities. It is helpful if parents are aware of school rules so they can help support them from home. Failure to return this acknowledgement will not relieve a student or the parent(s) from the responsibility for knowledge of the contents of the Code of Student Conduct.

    I have read:

    • Summary of Changes
    • The Annual Notice About Your Rights Concerning Student Records Including Releasing Information to Military Recruiters and Institutes of Higher Education (page 14) Directory Information Opt-Out form (page 17)
    • The Annual Notice of School Board Policy Required by The Protection of Pupil Rights Amendment (page 15)
    • The Notification of Availability of the School Public Accountability Report (2022-2023)
    • Florida Statute Allowing Blood Donation by 17 Year Olds
    • Social Security Notification
    • Pledge of Allegiance Notice
    • Extracurricular Activities Notification
    • Consent for Healthcare Services Form

    I have reviewed the 2023-2024 Code of Student Conduct.

    Additionally, it is acceptable to display my child’s good work.

    Parent/Guardian’s Signature Date

    Student’s Signature Date

    (PRINT) Student’s Name and Grade


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