Records Request Form

Request for Student Records & Consent to Release

Parents: please complete the following form which will be sent to your child's current school, so that they can release your child's records to Holy Family Cristo Rey. If you have any questions, please contact the Student Recruitment Office at admissions@hfcristorey.org
Student Information
Full Name *

First Name Middle Name Last Name Suffix
Birth Date *

Month Day Year
Date
Social Security Number
Current School *
Current Grade Level *
Records Requested
The above named student has applied for admission to Holy Family Cristo Rey Catholic High School. Please send the following records to assist us in processing his/her application. *

Copies of this year's most recent report card and last year's final report card Copy of any standardized test scores from the last two years Official Transcript (Transfer Students only) Any IEP, 504, or other records Copies of any discipline reports Health and Immunization records
Signature

I hereby authorize the above-named school to send all medical, academic, counseling, individual, and other records regarding my child to Holy Family Cristo Rey Catholic High School.
Parent/Guardian Signature *

Use your finger or a stylus to sign if on a touchscreen device, or a mouse if on a non-touchscreen computer. Clear
Parent/Guardian Full Name *

First Name Last Name
Today's Date

Month Day Year
Date
If you would like a confirmation email after submitting this form, enter your email address.
PLEASE NOTE: because of the sensitive nature of the data (i.e., social security number) submitted, this form is encrypted to keep your child's information secure. Because of this, our system will not allow us attach a copy of this form to an email. If you would like a copy of the form, please contact the Student Recruitment Office at admissions@hfcristorey.org.
Should be Empty:

Request for Student Records & Consent to Release