SCHOOL DISTRICT OF HILBERT
STUDENTS RECORDS REQUEST
STUDENT'S NAME | DATE OF BIRTH | GRADE |
TO:
(NAME OF PREVIOUS SCHOOL): |
(ADDRESS): |
(CITY/STATE/ZIP): |
The student(s) listed above enrolled in the School District of Hilbert starting:
_____________. Please send the following records at your earliest convenience.
- Records of Academic Performance
- Attendance
- Standardized Guidance Department Test Results
- Health Records
- Psychological Evaluation Reports
- Behavioral Files
►IF STUDENT HAS AN IEP OR 504 PLAN ON FILE, PLEASE FAX TO APPROPRIATE SCHOOL AS SOON AS POSSIBLE. ◄
PLEASE SEND RECORDS TO:
- Hilbert Elementary School □ Hilbert Middle/High School
1139 W. Milwaukee Street
PO Box 390
Hilbert WI 54129
Phone: 1-920-853-3558
Fax: 1-920-853-7030
NOTE: If a High School Student, please fax transcripts to: Mrs. Van Grinsven, School Counselor
Parent/Guardian Signature______________________________________________________ Date:_________________
NOTE: Parental permission is no longer required when records are requested by authorized school personnel. (Family Education Rights and Privacy Act, Final Rule on Education Records, Federal Register, June 17, 1976. Vol. 41,118, pf. 240734.