Editing previous response:

Please fix the highlighted areas below before submitting.

Records Request

Please complete the form below. Required fields marked with an asterisk *

Today's Date:*

Answer Required

Parent/Guardian First and Last Name*

Answer Required

Schools:

Name and Address of Previous School:*

Answer Required

Name and Address of Previous School:

Answer Required

Name and Address of Previous School:

Answer Required

Name and Address of Previous School:

Answer Required

To comply with "The Family Education Rights and Privacy Act of October, 1974", I give permission to the above named school(s) to send the following records:*

Answer Required

Transcript of courses, grades, attendance, and achievement test scores

Health Card and Immunization Information; other pertinent medical information

Special Education Records; Psychological Test Scores

Communication Disorders(Speech, Language, Therapy)

For the following students:

Student First and Last Name:*

Answer Required

Grade:*

Answer Required

Date of Birth:*

Answer Required

Student First and Last Name:

Answer Required

Grade:

Answer Required

Date of Birth:

Answer Required

Student First and Last Name:

Answer Required

Grade:

Answer Required

Date of Birth:

Answer Required

Student First and Last Name:

Answer Required

Grade:

Answer Required

Date of Birth:

Answer Required

Confirmation Email

Email Required