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Records Request
This form requires Javascript to be enabled for submission and authorization.
*
Required
Student Information
Student's Full Name
*
required
Please enter legal name
First Name
Nickname (optional)
Last Name
Please enter legal name
Date of Birth
*
required
Must contain a date in M/D/YYYY format
Requester Information
Requester Name
*
required
First Name
Last Name
Relation to Student
*
required
Email Address
*
required
Mailing Address
*
required
Phone Number
*
required
Record Request Details
Purpose of Request
*
required
Personal Use
School Transfer
Legal Proceedings
Other
Record(s) Requested
*
required
Official Transcript
Unofficial Transcript/Report Card
Graduation Verification
Immunization/Health Records
Attendance Records
Individualized Education Program (IEP)
Evaluation Reports
Discipline Records
Other (specify below)
Other Records Requested
Please specify any additional records not listed above
Method of Delivery
*
required
Mail to Address Provided
Email (secure & encrypted)
In-Person Pickup (ID required)
Authorization of Consent - by writing my name, I hereby request access to the specified student records for the purpose stated above. I understand that the release of these records is subject to applicable privacy laws and regulations, and I agree to use the information solely for the intended purpose.
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required
Date Requested
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required
Must contain a date in M/D/YYYY format
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