District 92 1/2 Permission to Release Student Records Form

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District 92 1/2 Permission to Release Student Records Form - Transfer Out of District 24-25

In compliance with the Family Educational Rights and Privacy Act, and the Illinois School Student Records Act, it is necessary that we have written permission from the parent of any student before his/her temporary academic and health records may be transferred to or from another school district. Please sign the statement below in order for your child’s records to be sent to his/her present school.

Email *

Student's Full Name (Last Name, First Name, Middle Name) *

Student Grade 2024-2025 *

Name of New School *

Address of New School (Include City, State, and Zip Code) *

Phone Number of New School, including area code *

Fax Number of New School, including area code *

Name of Registrar at new school *

Email address of Registrar *

Records will be emailed to this address

Student's New Home Address (Include city, state, and zip code) *

By my electronic signature below, I authorize District 92 1/2 to send my child's records to the school indicated above. *

A copy of your responses will be emailed to the address you provided.

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