Student Records Request Form
Name of Person Making Request
First Name *
Last Name *
Affiliation *
Address
Street Address *
City *
State *
Zip Code *
Phone *
List Email Used in Your Genesis Portal *
Release Location / Receiver *
Student Information
First Name *
Last Name *
Grade Level *
Student ID (if known)
Date of Birth *
MM
/
DD
/
YYYY
Year of Graduation if Student Graduated from Haddonfield
Last Year & Last School of Attendance *
Student’s Current Haddonfield School *
Type of Record(s) Requested *
Required
Additional Information / Notes
Submit
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