Request For Educational Records printable pdf download

Request For Educational Records

PO Box 161280

Big Sky, MT 59716

#72

CHOOL

ISTRICT

45465 Gallatin Road

Gallatin Gateway, MT 59730

406-995-4281

Fax 406-995-2161

REQUEST FOR EDUCATIONAL RECORDS

It is requested that the records of _________________________________________________

Student’s Name (Please Print)

__________________________

____________________

Birthdate

Grade (going into)

Be obtained from: ______________________________________________________________

Address: ______________________________________________________________

Fax #: ______________________________________________________________

Please release the following records:

________ SCHOOL CUMULATIVE RECORDS

________ PSYCHOLOGICAL STUDIES/REPORTS/CONFIDENTIAL FILE

________ MEDICAL/IMMUNIZATION INFORMATION

________ OTHER (SPECIFY)

New Federal 99.31 requires no parent signature for educational records sent to another education

agency.

I hereby authorize release of the above records:

Signature of Parent/Guardian: ____________________________________________________

School Official: ________________________________________________________________

Please send these records to: Big Sky School District #72

PO Box 161280

Big Sky, MT 59716

Request For Educational Records