Document not found! Please try again

Transcript Release.pdf - Google Drive

0 downloads 202 Views 71KB Size Report
PERMISSION FOR RELEASE OF SCHOOL INFORMATION. Under Provisions of Delaware Code, Title 14, Chapter 41, Section 4111 here
NEWARK CHARTER DISCLOSURE OF PUPIL’S RECORDS PERMISSION FOR RELEASE OF SCHOOL INFORMATION

Under Provisions of Delaware Code, Title 14, Chapter 41, Section 4111 hereby authorizes the Chief School Officer or his designated representative to: Check (X) 1 or 2 below, filling in spaces as needed. Please note that selecting #2 will streamline the process of applying to colleges. _____1.

Release school record information deemed necessary to: _____________________________________________ (Name of school, employer, institution or physician)

_____2.

Release school record information to any school, college, university, institution, employer or prospective employer, or physician. No further signed release forms need be completed by the undersigned to expedite release of school record information to the recipients herein named.

_________________________________________ Student’s name

_______________________ Date

______________________________ Signature of Parent

_______________________________________ Student’s email address