Student Record Request Form

Student Record Request Form

North County Christian School
Current Date:

MonthDayYear
Date
Student's Name:

First NameLast Name
Student's Birthdate:

DayMonthYear
Date
Student's Grade Level:
Name of School Requesting Records:
example@example.com
Student's First Date of Enrollment at Your School?:

MonthDayYear
Date
Your Name:

First NameLast Name
Your Position/Job Title:
Your Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Your Email:
example@example.com
Reason for Request:

New School of AttendanceFile ReviewSpecial Needs AssessmentOther
Which records are you requesting?:

Entire Cumulative FileIEP and SPED FileReport CardsOther
How would you like the records sent?:

EmailMail
Email to send records:
example@example.com
School address to send records:

School Name

Street Address

CityState / Province

Postal / Zip Code
Attention:

First NameLast Name
Your Signature:
Should be Empty: