REQUEST FOR RECORDS
The student listed below has enrolled in Bentley Schools. Please forward CA-60, immunization, transcript, and any behavior report records for this student:
City, State, Zip Code:
PLEASE SEND RECORDS TO (Check one):
1150 N. Belsay Road
⃣ Parent indicated that student was receiving Special Education services. Please fax copies of the current IEP, most recent Re-Evaluation and MET and psychological evaluation to the Bentley Special Services office.
⃣ Parent indicated that student was not receiving special Education services, but please check records and, if present, fax copies of the current IEP, most recent re-evaluation, and psychological evaluation to the Bentley Special Services office.
Bentley Special Services Office
1150 N. Belsay Road, Burton, MI 48509
Signature of Parent/Guardian _____________________________________________ Date _______________________