Student Records Request

Type of Student

Request Information

Student Information

School Information

Requestor Information

Acceptance & Digital Signature

  • By typing your full name, last 4 of your social security number and checking the acceptance box you:

    •  Accept the rules of this form
    •  Agree that all information contained is accurate
    •  Confirm that you are the individual referenced or the guardian of the individual referenced through out the form and the acceptance section and agree to use this as your Electronic signature.
  • Date captured on form submission

Hidden Fields

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