506.01 E3 - Education Records Access - Request for Hearing on Correction of Education Records

REQUEST FOR HEARING ON CORRECTION OF EDUCATION RECORDS

 

To:____________________________________ Address: _______________________

             Board Secretary (Custodian)

 

I believe certain official education records of my child, ______________________, (full legal name of student), ___________________(school name), are inaccurate, misleading or in violation of privacy rights of my child.

 

The official education records which I believe are inaccurate, misleading or in violation of the privacy or other rights of my child are:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

The reason I believe such records are inaccurate, misleading or in violation of the privacy or other rights of my child is:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

My relationship to the child is: _____________________________________

 

I understand that I will be notified in writing of the time and place of the hearing; that I will be notified in writing of the decision; and I have the right to appeal the decision by so notifying the hearing officer in writing within ten days after my receipt of the decision or a right to place a statement in my child's record stating I disagree with the decision and why.

 

 _____________________________________

                      (Signature)

Date:___________________________________

Address:_________________________________

City: ____________________________________

State: ______ ZIP:_______________

Phone Number: ______________________

 

Approved: October 14, 2024

Reviewed: January 17, 2005; March 21, 2011; January 19, 2015; August 19, 2019; October 14, 2024

Revised: October 14, 2024