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School Official use only for Transferring Student Records from School to School
This request form is for school use only. The Family Educational Rights and Privacy Act of 1974 allow schools to disclose information from a student’s education record without consent/written permission from the parent to other schools to which a student is transferring.
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* Indicates required question
Email
*
Your email
Date of Request
*
MM
/
DD
/
YYYY
JCS Family of Charter Schools
*
Please select the Julian Charter School (JCS) the student attended.
Choose
Julian Charter (LIVE)
JCS - Cedar Cove
JCS - Manzanita
JCS - Mountain Oaks
JCS - Pine Hills
JCS - Pine Valley
Type of Records Request
*
Choose
General Ed Records
Special Ed Records
Both General Ed and Special Ed Records
For students with an IEP, does the student's new school use SEIS
*
Select N/A, if the student doesn't have an IEP.
Choose
Yes
No
N/A
Student's Legal Last Name
*
Your answer
Student's Legal First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Current Grade
*
Choose
TK
KN
1
2
3
4
5
6
7
8
9
10
11
12
CA SSID Number
Your answer
Name of New School
*
Your answer
First Day of Attendance at New School
*
MM
/
DD
/
YYYY
Name of School Employee Requesting Records
*
Your answer
School
Contact Phone Number
*
Your answer
Student Records to Send
*
Mail
Email
Fax
N/A
Cumulative File
Special Education Records (including IEP)
Section 504 Plan
Immunization and Health Records
Attendance Records
State Test Results
Official Transcript
Unofficial Transcript
Progress Report
School Profile
Discipline Records
Mail
Email
Fax
N/A
Cumulative File
Special Education Records (including IEP)
Section 504 Plan
Immunization and Health Records
Attendance Records
State Test Results
Official Transcript
Unofficial Transcript
Progress Report
School Profile
Discipline Records
Do you want the physical records mailed to you?
*
Choose
Yes
No
School Physical Street Address to mail records
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
School
Fax Number to send copies
Your answer
Additional Information
Your answer
Send me a copy of my responses.
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