Joel E. Barber Request of Records Form
* Required
Student full LEGAL name
*
Your answer
Student's Grade
*
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Name of Previous School with City and State
*
Your answer
Email (or phone) of school contact for records
*
Your answer
By signing this form, I understand that this transfer is provided for in the Family Educational Rights and Privacy Act of 1974, as amended June 17, 1976. The new regulations no longer require an acknowledgment for the parent or eligible student that he or she has received notification before records may be released to other educational institutions.
*
I agree
As the parent/legal guardian of the above-listed student, I give permission for the institution above to transfer records for the above-named student to the Laclede County C-5 Joel E Barber School District. This is a one-time records request. My electronic signature is my acknowledgement and agreement that my child's educational records will be requested. Please type your name below.
*
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Joel E. Barber C-5 School.
Report Abuse
Forms