St. Mary's Parish School - Records Request

St. Mary's Parish School - Request for Release and Transfer of Student Records
Transferring School Name:
Transferring School Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Name:

First NameLast Name
Grade Entering
Date of birth

MonthDayYear
Date
Place of Birth
Parent(s) Name:

First NameLast Name
Parent(s) Signature:

Clear
Date:

MonthDayYear
Date
This student has enrolled at St. Mary’s Parish School. Please release and transfer all school records, files, and data for this student including:
Student Progress Records:

Permanent records (birth certificates, health records, achievement test scores, academic work completed, attendance, level of achievement, grades, marks, and grade placement, etc.)
Upload Progress Reports

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Special Education Records:

Testing information, Individualized Education Plan (IEP) and/or 504, and all other pertinent information.
Upload special education reports

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Student Behavioral Records:

Background and test information, anecdotal records, verified reports of serious or recurrent behavioral patterns, and medical records.
Upload Student behavioral records

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Should be Empty:

St. Mary's Parish School - Request for Release and Transfer of Student Records