SoCal Collaborative Records Request Form
This form is only for schools or other agencies requesting records. If you are a parent, please email our Records Department (records@) with details of your request. If you are a School/Agency official, please complete this form to request a student's records.
Select Name of Student's Charter School
*
Please Select
Cabrillo Point Academy
Mission Vista Academy
Pacific Coast Academy
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Student's Name
*
First Name
Last Name
Student's Date of Birth
*
-
Month
-
Day
Year
Date
Student's Grade Level
*
Please Select
TK
KN
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
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I am a...
*
Please Select
School/Agency Requesting Records
Requestor's Name
*
First Name
Last Name
Requestor's Email
*
example@example.com
Requestor's Job Title
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of your School or Place of Employment:
*
Reason for Request
*
New School of Attendance
Other
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Student's First Date of Enrollment at Your School
*
-
Month
-
Day
Year
Date
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Does the student have an IEP?
*
Yes
No
Unsure
Please send the following records
*
Entire Cumulative Record
Transcript
Other
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Email Address:
*
example@example.com
Mailing Address:
*
First Name
Last Name
Mailing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Requestor's Signature:
Submit
Should be Empty: