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Athens Area School District Child Accounting Office 100 Canal St Athens, PA 18810 Phone: 570-888-7766  Fax: 570-882-6250 Email: [email protected] Lynda Harkness, Registrar
PERMISSION TO RELEASE RECORDS To Whom It May Concern: The student listed below formerly attended your school and registered in our district on Student Name:  Date Of Birth:  Grade:
Former School District Name: Former School Building Name: Former School Address: Former School Phone #: Fax #:
The above student has enrolled in the Athens Area School District. Please forward all school records pertaining to this student. Records to include, but not limited to: Health and immunization records Transcript of Grades, Withdrawal Grades Previous Report Cards Standardized Test Results Attendance and Guidance A certified copy of the student’s Disciplinary Record Special Education Records, including: Initial Evaluation Report, Most recent Reevaluation Report, Current IEP, Notice of Recommended Educational Placement/Related Services, any additional documents relevant to providing the student with appropriate educational services and support.
We agree to the release of any and all records to the Athens Area School District. Signature of Parent Date Signature of Student (if 18 years old or older) Date