506.1E2 AUTHORIZATION FOR RELEASE OF STUDENT RECORDS

Code No.  506.1E2

                                                           

 

AUTHORIZATION FOR RELEASE OF STUDENT RECORDS

 

 

The undersigned hereby authorizes Morning Sun Community School District to release copies of the following official student records concerning:

 

                                                          

 

                                    (Full Legal Name of Student)    (Date of Birth)

 

 

                                                                 from 19    to 20    

                                    (Name of Last School Attended) (Year(s) of Attend.)

 

The reason for this request is:                                                

 

                                                                               

 

My relationship to the child is:                                               

 

Copies of the records to be released are to be furnished to:

 

                        (  )  the undersigned

                        (  )  the student

                        (  )  other (please specify)                                          

 

 

                                                                                                    

                                                            (Signature)

 

                                                            Date:                                   

                                                            Address:                                

                                                            City:                                   

                                                            State:                        ZIP       

                                                            Phone Number:                           

 

 

 

 

 

 

 

 

 

 

MORNING SUN COMMUNITY SCHOOL DISTRICT BOARD OF DIRECTORS