Terra Nova School - Records Release of Information
Formerly Jane Goodall Environmental Sciences Academy in Maple Lake, MN
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Record requested by (students/alumni 18 or older must request their own): *
Student's First Name: *
Student's Last Name: *
Name used when at Terra Nova (formerly Jane Goodall Environmental Sciences Academy), if changed (ie: maiden name):
Record(s) being requested: *
Required
I need my records for: *
Date of Birth *
MM
/
DD
/
YYYY
Year of Graduation *
I would like my records to be: *
Records should be sent to the attention of:
Email, fax number, or address (include city, street, and zip) where records should be sent, unless being picked up:
Please prepare this number of copies: *
What phone number can you be reached at? *
Type your name below to agree to the following statement: In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), the parent, legal guardian, or educational rights holder of the student whose name appears above, authorizes Terra Nova School to release records to the school/organization/person listed above. *
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