Glen
908-638-6116
Fax: 908-638-6355
This form is to be completed by parent and submitted to
the school your child most trecently attended.
Current school will then forward records to
DATE: __________________
To: _____________________________________
(Name
of former school)
Address of former school: ________________________________
________________________________
Phone number of former school: ___________________________
Attention: Guidance Department/Student Records
The following student has registered at
____________________________________ ____________________.
Student Name (Grade)
Please forward the following records (if applicable)
at your earliest convenience:
Scholastic
Records (including
official transcript, current grades, standardized testing)
Explanation of grading system
(If letter grades are given please give numerical equivalent).
Health/Immunization Records
Child Study Team Records
256
Route 513
Glen
I hereby authorize the release of
academic and medical records for the above named student to