Release School Records Form | Pastoral Region Xii

Confidential Request For Release or Transfer of School Records

Records Will Be Released After All Financial Arrangements Have Been Met.

St. Peter Catholic School provides this form for the purpose of obtaining or releasing your child’s school records.

Name of Child
First Last
Birth Date
Month
Day
Year
Address of Child
Street Address Address Line 2 City State ZIP Code
Current Grade Level
I hereby authorize St. Peter School to:
- obtain from
- release to
Name of School
Address of School
Street Address Address Line 2 City State ZIP Code
School Phone Number
Please Include all Academic, Medical, and Psychological Records.
Parent/Guardian Signature
Date
Month
Day
Year
Relationship to Child
Principal Signature
Date
Month
Day
Year