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Registration Release, Ethnicity, Language
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* Indicates required question
Email
*
Your email
AUTHORIZATION FOR RELEASE OF SCHOOL RECORDS
By fill out this form you are giving permission for the previous school to release student records to Stark County District #100.
Student Full Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Grade Entering
*
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Enrollment Date
*
The above student enrolled in Stark County #100 on:
MM
/
DD
/
YYYY
Parent Signature
*
Parent gives electronic permission to release records
Your answer
Today's Date
*
Date granting permission to release records:
MM
/
DD
/
YYYY
School Name
*
Name of Previous School last attended
Your answer
School Address
*
Address of school last attended
Your answer
Phone Number
Please give the phone number of last school
Your answer
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