CLICK HERE TO DOWNLOAD PARENTAL REQUEST FOR EXAMINATION OF EDUCATION RECORDS
To: (Name of Student Attendance Center)_______________________________________
Address (Of Student Attendance Center) _______________________________________
As ________________________________________ (Relationship to Student) of ______________________________(Name of Student)
who was born on ________________________________________ and is currently in grade _________________________________.
I request to examine the following official education records:
_____________________________________________________________________________________
_____________________________________________________________________________________
Please check one of the following:
_____ I do
_____I do not
desire a copy of such records and I understand that a reasonable charge will be made for copies, if requested.
Signature: ________________________________ Date: ____________________________
Address: ___________________________ City: ____________________ State: ________ Zip: __________
Phone Number: _________________________________
Approved By:
Signature: _______________________________ Title: ________________________ Date: _________
Adopted: 9/98
Reviewed: 7/13; 10/14; 12/20; 10/23
Revised: 8/07; 8/17; 10/19
Related Policy: 505.6; 505.6-R; 505.6-E2-E4; 505.6-E6-E7
IASB Reference: 506.01-E(4)