Audubon Schools Records Request Form

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Which school would you like to request from: *

Audubon Uptown - Lower School

Audubon Uptown - Upper School

Audubon Gentilly

Which district would you like to request from:

Date of Request: *

Student's Name: *

Homeroom Teacher: *

I would like to request copies of my son's/daughter's: *

Final Report Card from year_________

Testing History (LEAP Scores)

Other (IEP, DIBELS, 504)

Required

Parent/Guardian's Name *

Parent/Guardian's Contact Number *

Parent/Guardian's Email *

REMINDER:

Please note that Records Requests take at least 24 hours to process. Please keep these documents as your new originals and remember to make any additional copies as needed. Additional copies/requests from the school will be charged $1.00 per page. Thank you.

Delivery/Pick Up: *

I will come to school to pick up this information on ________________

Please send this information home with my student. (Parent Initials ___________________)

Thank you in advance, please sign below.

______________________________________________________________________________________

For office use only:

Date completed: ___________________________

Total cost of copies $_________________________

Notes:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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