Student Directory Opt-Out

RCMS PTA 2017-18 School Directory Opt-Out Form 

MUST BE COMPLETED AND SUBMITTED TO RACHEL CARSON MIDDLE SCHOOL (“RCMS”) OFFICE BY SEPTEMBER 30, 2017


SUBMIT THIS FORM ONLY IF YOU DO NOT WANT YOUR STUDENT’S ADDRESS AND PHONE NUMBER LISTED IN THE STUDENT DIRECTORY

The RCMS PTA (the “PTA”) will create a 2017-18 School Directory (the “Directory”).  All PTA Members (the “Members”) will receive a copy of the Directory FREE!

NOTE: The PTA is not responsible for any unauthorized access to the Directory that may be obtained by others within or outside of the RCMS community. Reasonable efforts will be taken to protect personal information published; however, the PTA does not guarantee the security of your personal information.

Inclusion in the Directory is optional.  All RCMS students and families will be automatically included unless you submit this Directory Opt Out Form.

If you do not wish your contact information to be included in the Directory, the PTA must receive this completed DIRECTORY OPT OUT FORM by September 30, 2017.
You may turn your completed Opt Out Form in to the RCMS Office.

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I do not want my child’s address and phone number printed in the Directory.  PLEASE PRINT!

Parent/Guardian Signature: ________________________________ 

Parent/Guardian Printed Name: _____________________________ 

Student’s Full Name: ______________________________________

Student’s Grade: __________

Click here to print the form.