Student Records Request Form

Please take note of the following: Parent/Guardian must submit this Records Release Authorization Form if the student is under 18 years of age.

Please allow 3-5 working days for transcripts/records to be sent out.

Electronic transcripts are free of charge unless they need to be expedited.

Contact colleen.johnson@msa.state.mn.us with questions

Student Name (while attending MSAD or MSAB)*

School for the BlindSchool for the Deaf

Current StudentPast StudentGraduate

Last School Year Attended*

Record requests for students who attended prior to 2003 will need to contact the Minnesota Historical Society, where student records are archived. Former students will need to contact them directly to request the release.

Minnesota Historical Society
345 W. Kellogg Blvd.
St. Paul, MN 55102
651-259-3000 • 1-800-657-3773
https://www.mnhs.org/preserve/ records/index.php

Official transcript and/or report cardsStandardized achievement test scoresHealth Records (including immunization records)Special Education records (IEP, evaluations, psychological, etc.)Attendance recordsOther

Where should records be sent? (Address, Email, Fax or weblink)*

Upload release of records (if available)

Requester Signature - I authorize the release of student documents listed above (Please sign here)*

Requester Name*

Your Email*

example@example.com

Your Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Date*

MonthDayYear