John Muir Charter Schools Student Records Request

John Muir Charter Schools Student Records Request

Disclaimer: This form is to be completed by the student only. 3rd party representatives can fax student record requests along with a signed student release to (530) 272-4009.
What type of record are you requesting? *

Transcript Diploma Copy
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Address *

Street Address

Apartment or Unit #

City State

Zip Code
Phone Number *
Email *
example@example.com
Name of last JMCS site attended
Last year attended
Did you graduate? *

Yes No
Student record to be sent by: *

Email Mail Fax
Email
example@example.com
Fax Number
Name

First Name Last Name
Address

Street Address

Apartment or Unit #

City State

Zip Code
Additional Information/Comment
By clicking on "SUBMIT" you are signing this request electronically and agree that your electronic signature is the legal equivalent of your manual signature. By selecting "SUBMIT", you are giving your consent for the release of your student records.
Should be Empty: