Student Records Request
For current students, records will be emailed through our Jupiter portal.
Requestor's Name
*
First Name
Last Name
Requestor's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
1st Student's Name
*
First Name
Last Name
19-20 Grade
*
K
1
2
3
4
5
2nd Student's Name
First Name
Last Name
19-20 Grade
*
K
1
2
3
4
5
3rd Student's Name
First Name
Last Name
19-20 Grade
*
K
1
2
3
4
5
Records Requested (check all that apply)
19-20 Report Card
18-19 Report Card
Medical Records
IEP
504 Service Agreement
Discipline Records
Attendance Record
No. of Copies Requested:
*
1
2
3
4
5
6
7
8
9
10
How would you like these records sent to you?
Signature
*
Clear
Save
Submit
Should be Empty: