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Magruder HS Record Release Form
MAGRUDER HIGH SCHOOL School Counseling Services
5939 Muncaster Mill Road
Rockville, MD 20855
Telephone: 240-740-5569
Fax: 301-840-4617
NO RECORDS WILL BE SENT WITHOUT THE COMPLETION OF THIS FORM.
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* Indicates required question
Student ID
*
Your answer
Student Last Name
*
Your answer
Student First Name
*
Your answer
Authorization for Release of Student Records: I authorize Magruder High School Counseling Department to release records to requested post-secondary institutions or prospective employers for the student named above.
*
Yes
No
Waiver of Right to Review Counselor/Teacher Recommendation: I hereby waive my right to review the secondary school report and counselor recommendation and as well as teacher letters of recommendation.
*
Yes
No
Student Signature:
*
Your answer
Date:
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MM
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/
YYYY
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