School Official use only for Transferring Student Records from School to School
This request form is for school use only. The Family Educational Rights and Privacy Act of 1974 allow schools to disclose information from a student’s education record without consent/written permission from the parent to other schools to which a student is transferring.
Sign in to Google to save your progress. Learn more
Email *
Date of Request
 *
MM
/
DD
/
YYYY
JCS Family of Charter Schools *
Please select the Julian Charter School (JCS) the student attended.
Type of Records Request *
For students with an IEP, does the student's new school use SEIS *
 Select N/A, if the student doesn't have an IEP.
Student's Legal Last Name *
Student's Legal First Name *
Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
CA SSID Number
Name of New School *
First Day of Attendance at New School *
MM
/
DD
/
YYYY
Name of School Employee Requesting Records *
School Contact Phone Number *
Student Records to Send *
Mail
Email
Fax
N/A
Cumulative File
Special Education Records (including IEP)
Section 504 Plan
Immunization and Health Records
Attendance Records
State Test Results
Official Transcript
Unofficial Transcript
Progress Report
School Profile
Discipline Records
Do you want the physical records mailed to you?
 *
School Physical Street Address
 *
City *
State *
Zip Code *
School Fax Number to send copies
Additional Information
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Julian Charter School.

Does this form look suspicious? Report

Google Forms