Request for Student Records

Request for Student Records

Please complete this form. We will send to the school system.
Full Name of Student

First NameLast Name
Current School
Current Grade
I am in the process of enrolling my child(ren) in Christian Heritage Academy for the following school year:
School year
I am authorizing release of all records and information to CHA and hereby request that they be sent within the next 10 days. Please include the following information:
1. A transcript of the student's record, including grades
2. A copy of all behavioral records
3. A copy of any custodial records
4. A copy of all psychological reports
5. A copy of all standardized testing data
6. A copy of immunization records
7. A copy of any confidential data
8. A copy of any tutoring/special academic arrangement records
9. A copy of any transfer records from other schools
Thank you.
Parent/Guardian's Signature

Clear
Please mail records to:

Admissions Department, Christian Heritage Academy

625 Glennwood Drive, Rocky Mount, VA 24151

Or email to: admissions@chaknights.org

**Records are used for review during the admissions process. Please do not withdraw this student from your school until further notification.
Should be Empty: