Student Evaluation Report Request Form
Need a copy of a student's evaluation report? Use this form to formally request access to a student’s evaluation records. The fee to receive the report is $500. Once the request is received, our team will follow up with payment instructions. Reports will be delivered within 7 business days upon confirmation of payment. If additional authorization is required, you will be contacted directly.
Student Name
*
First Name
Last Name
Campus
*
Please Select
Caddo
Capital Region
Northshore
Ruston
Student Date of Birth:
*
-
Month
-
Day
Year
Date
Primary Parent / Guardian
*
First Name
Last Name
Parent / Guardian Mobile Phone Number
*
Please enter a valid mobile phone number.
Parent / Guardian Email
*
example@example.com
Make Payment
*
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Student Evalution Report
$
500
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Submitter Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Today's Date
Please read and check the following statements confirming acknowledgment and agreement:
*
Processing Fee: A non-refundable processing fee of $500 is required for each evaluation report request. Payment must be received in full before processing will begin.
Turnaround Time: Please allow up to 7 business days for processing once payment has been confirmed. Delays may occur if additional documentation or authorization is required.
Authorization & Privacy: Evaluation reports contain sensitive student information and will only be released to individuals with verified legal authorization or signed parental/guardian consent, in accordance with FERPA and applicable privacy laws.
Method of Delivery: Reports will be delivered via secure electronic means. Incomplete or inaccurate contact information may result in delays.
Use of Information: The evaluation report is intended solely for the use of the requesting party and may not be reproduced, distributed, or used for purposes other than those originally stated without prior written permission.
No Guarantee of Outcome: Submitting this request does not guarantee that a report will be available or released. Requests may be denied if required authorizations are not provided.
Certification of Accuracy
*
By my signature, I acknowledge and agree to all of the terms and conditions listed above.
Please verify that you are human
*
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