Student Records Request Form

Student Records Request Form

Enter the student and previous school details, then complete the parent signature and printed name. Please complete this form for each school from whom we will be requesting records.
Student's Full Name

First NameLast Name
Student's Date of Birth

MonthDayYear
Date
Student's Grade
Previous School Name
Previous School Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Previous School Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Previous School Fax Number
Previous School Email
example@example.com
Is there another student from this school for whom we need to request records?
Student 2 Full Name

First NameLast Name
Student 2 Date of Birth

MonthDayYear
Date
Student 2 Grade
Is there another student from this school for whom we need to request records?
Student 3 Full Name

First NameLast Name
Student 3 Date of Birth

MonthDayYear
Date
Student 3 Grade
Is there another student from this school for whom we need to request records?
Student 4 Full Name

First NameLast Name
Student 4 Date of Birth

MonthDayYear
Date
Student 4 Grade
Parent/Guardian Printed Name

First NameLast Name
Parent/Guardian Signature
Should be Empty: