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Forms

Family Educational Rights & Privacy Act Opt Out Form (Directory Info Opt-out)

FERPA protects the privacy rights of student records and applies to all schools that receive federal funding. Under FERPA, the Centralia School District may disclose certain types of records, known as directory information, without consent. This includes your child's name, their participation in sports and activities, degrees and honors receive4d, dates of attendance, and previously attended schools. You may opt-out of the release of this information by returning the Directory Opt Out Form to your child's school.

Flyer Distribution Form

If your non-profit organization would like to have copies of flyers or other materials distributed within the District, you must submit the Flyer Distribution Form to the District Office. You must also include a copy of the materials you would like to distribute. All distributions are subject to administrator approval.

Report Harassment, Intimidation, or Bullying (online form)

Bullying is a serious matter, and all reported incidents will be investigated and acted upon as appropriate. Use the above form to report an incident of Harassment, Intimidation, or Bullying.
 

Facility Use Request Form

Please use this form to request the use of Centralia School District facilities for private functions. Note: Fees apply, they are indicated on the Facility Use Request Form.  Non-profit organizations must have proof of 501(c)3 status. Click here to read the CSD guidelines for the use of school facilities.
 

Stadium Facility Use Request Form

Please use this form to request the use of Tiger Stadium for private functions. Note: Fees apply.

Authorization for Mutual Exchange of Information Form 

Use this form to authorize the mutual exchange of student information between the Centralia School District and other entities (schools, physicians, psychologists, hospitals, clinics, etc.)

My TRL (Timberland Regional Library) Opt-Out Form

Centralia School District and the Timberland Regional Library (TRL) have formed a partnership to provide students access to a wider range of resources from the library’s electronic services collection. Students will be able to view and check out electronic library resources (ebooks and audiobooks) that are automatically returned. Watch this 2 minute video to learn more. Access to MyTRL will begin January 2, 2023. Parents may choose to opt out of the MyTRL program at any time through Skyward Family Access or they can submit an opt-out form to the school office.
Click below for MyTRL Opt-Out Instructions in English. Click below for MyTRL Opt-Out Instructions in Spanish. 

Photo Opt-Out Form

The Centralia School District often uses photos of students in District publications (newsletters, pamphlets, etc.), in news releases, and on District maintained websites or social media accounts. The purpose of this use is to help distribute information about the Centralia School District. If you do not want your child's image used in publications, news releases, or on websites/social media, please return the Photo Opt-Out Form to your Child's school.  Please note, we cannot always control how other entities use images they obtain on their own.

Verification of Residency Form

Intent to Home School
(Due September 15th annually)
 
 
Tort Claim Form- 6500F
 
Pursuant to Chapter 4.96 RCW, this form is for filing a tort claim against the Centralia School District No. 401. Some of the information requested on this form is required by Chapter 4.96 RCW and may be subject to public disclosure.