Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Food Service Email Release Form

  1. The Federal Education Rights and Privacy Act is intended to insure the privacy of personal financial information, by specifically preventing employees or staff of Riley County from releasing details or discussing the status of individual financial accounts with anyone other than the individuals included in the account and appropriate employees or staff. In addition, Riley County may not send e-mails containing such information, nor respond to e-mail requests for such information, unless an e-mail release form is on file in the Food Service Department. If you have a current e-mail address and you would like to be kept informed of your meal account status by e-mail, and have the School District and/or Food Service Department use it to correspond with you, please complete the following form.

    CERTIFICATION: I hereby request the USD 378, Riley County School District and the Food Service Department to which I am applying accept this authorization to release confidential financial information to me, related to my school lunch account via the e-mail address listed below. I understand electronic mail is a less secure environment than the postal service. I understand regardless of whether or not I grant permission to have emails sent to me, my school lunch account information will be available to me via the Internet, where it can only be accessed with a secured sign-in procedure, using my family account number and a PIN. Faculty and staff of the Riley County School District USD 378 are not held liable for the release of information permitted by this agreement. This release form stays in effect until revoked by me in writing, or through e-mail notification, or verbal authorization. If I should leave or transfer from Riley County School District for any reason this release form is no longer valid.

    Submittal of this Email Release Form constitutes consent.

  2. Leave This Blank:

  3. This field is not part of the form submission.