Consent for Transfer of School Records Form

Consent for Transfer of School Records

In accordance with the Ontario Student Record (OSR) Guideline published by the Ministry of Education and the Provisions of Municipal Freedom of Information and Protection of Privacy Act, CROWN ACADEMY requires consent from the parent or guardian to request student record.
Name*

First NameLast Name
OEN (Ontario Education Number)*
give authority to Crown Academy to obtain the OSR from:
Current School Name*
Address of Current School*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Current School*

Area CodePhone Number
Fax Number of Current School

Area CodePhone Number
Parent’s or Guardian’s Signature

Clear
Student Signature (for student’s 18 or over)

Clear
Date*

YearMonthDay
Date
Principal Signature

Clear
Date

YearMonthDay
Date
Should be Empty: