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Confidential Release Form
The purpose of this section is to provide consent for your child's previous school district to release your child's academic records to the Malone Central School District. If your child attended another school district, this is absolutely necessary so that we may ensure your child receives credit for work completed and is scheduled for classes and services that are needed.
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* Indicates required question
Email
*
Your email
First name of student:
*
Your answer
Middle name of student:
*
Your answer
Last name of student:
Your answer
Student's date of birth:
*
MM
/
DD
/
YYYY
Grade:
*
Choose
Pre-K
Kindergarten
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Name of the school district your child most recently attended:
*
Your answer
Town/city where that school district is located:
*
Your answer
State in which that school district is located:
*
Your answer
Zip code in which that school district is located:
*
Your answer
Phone number for that school district:
Your answer
Fax number for that district:
Your answer
Name of parent/legal guardian completing this form:
*
By typing your name below, you are providing your consent for your child's previous school district to release your child's records to the Malone Central School District.
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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