RELEASE OF RECORDS
Brooklyn Elementary School
119 Gorman Road
Brooklyn, CT 06234
Phone: 860-774-7577
Fax: 860-779-1162
STUDENT NAME: *
DATE OF BIRTH: *
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In regards to the above child, I hereby authorize The Brooklyn School to do the following with my student´s records: *
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In regards to the above child, I hereby authorize The Brooklyn School to do the following with my student´s records: *
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Please include the following records: *
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School Transferring From (Name of school, address, phone number, fax number): *
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