Records Release Form

Records Release Form To Parent or Guardian Please complete this form, sign where indicated, and deliver to your child's current or most recent school. The request of records and information listed below should be postmarked as soon as possible. This form is for you, the parent, to submit directly to your student's current and/or previous schools. Name of Student: Date of Birth As parents/guardians of the student named above, I request and authorize the release of school records, including a complete transcript (current and previous year's grades) and results of any standardized tests, behavior records/evaluations directly to Ad*al-Farragus Academy. irtpicig. tand that the records are confidential. Parent/Guardian Signature: To the School Head or Registrar Date 017 The student named above is applying to Admiral Farragut Academy. To help us evaluate this student, please send the student's transcript (a copy of current and previous year's grades), standardized test results, and any behavior records/evaluations on file to us at your earliest convenience. Thank you for your assistance. Information to be released should include the following: • Signed, stamped, and sealed official transcript (cannot be scanned, emailed, or faxed) • Academic records for the current year, as well as the previous 3 years (if applicable) • Disciplinary Records (if applicable) • Final transcripts upon the student's withdrawal - mid semester or end of year Postmark or express ship official transcripts to: Admissions Office Admiral Farragut Academy RECEIVED JUN 2 9 2011 International students' transcripts must be submitted in original language as well as translated into English by a certified translator wwwfarragut org Records Release Form Rev 09/101:5 EFTA00605841