505.01 E6 - Notification of Transfer of Student Records

To:                                                                                           Date:                                                   Parent/or Guardian

 

            Street Address:                                                                                                          

 

            City/State:                                                                               Zip:                             

 

            Please be notified that copies of the                                                                          

 

            Community School District’s official student records concerning                            

 

                                                            (full legal name of student) have been transferred to:

 

 

           

                                                                                                                                               

            School District Name                                     Address

 

            upon the written statement that the student intends to enroll in said school system.

 

            If you desire a copy of such records furnished, please check here ______ and return

            this form to the undersigned.  A reasonable charge will be made for the copies.

 

            If you believe such records transferred are inaccurate, misleading or otherwise in

            violation of the privacy or other rights of the student, you have the right to a hearing

            to challenge the contents of such records.

 

 

 

                                                                                                                                               

                                                                                    Name

 

 

                                                                                                                                               

                                                                                    Title

 

 

(January 17, 2005; March 21, 2011; January 19, 2015; August 19, 2019)