• REQUEST AND AUTHORIZATION FOR RELEASE OF STUDENT RECORDS

  • UTOPIAN ACADEMY FOR THE ARTS

  • STUDENT INFORMATION

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  • SCHOOL RECORDS ARE REQUESTED FROM

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  • RECORDS TO BE RELEASED

    Authorization to release the following information:
  • Cumulative record including grades and attendance

    Report Cards with current grade averages and academic transcript

    Immunization and health/medical records

    Standardized test scores

    Discipline Records

    Special placement records and reports (including IEP, EIP, Speech, 504Plan)

  • RELEASE SCHOOL RECORDS TO

  • Please send documents to:

    FAX: (770) 234-6707
  • PARENT/LEGAL GUARDIAN SIGNATURE

  • I, the parent/legal guardian of the above named student, hereby authorize the above named school to release any of the listed school records to Utopian Academy for the Arts. This request shall serve also serves as notification that the above-listed student is now enrolled in Utopian Academy for the Arts. All information obtained will be treated in a confidential manner by Utopian Academy for the Arts under the provisions of the Family Education Rights and Privacy Act (FERPA).

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  • * Per Ga DOE Board Rule 160-5-1-14 schools must main or otherwise deliver requested records within te (10) calendar days of receipt of request. Schools shall NOT withhold any student record due to non-payment of fees Georgia requires that all students entering Georgia schools for the first time, regardless of grade level, provide a shot record (immunization) record showing that they are adequately immunized. Please include this immunization record in your release, if available. Elementary School Registrar- A. Thomas; albert.thomas@utopianacademy.com Middle School Registrar- A. Calvin; angelic.calvin@utopianacademy.com

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