Parent Authorization for Release of School Records

Parent Authorization for Release of School Records
This form will be submitted to the school where records/personal information are currently on file. In order for your child’s educational records to be transferred, please provide all of the information requested below.

Name of School:
Address:
City/State/Zip:
Telephone Number:
Fax Number:

I hereby authorize the release copies of records listed below to Montessori School of Mauldin:

• 
  Transcripts
  
• 
  Attendance & Behavior Records
  
• 
  Immunization Record
  
• 
  Standardized Test Results
  
• 
  Psychological Test Results, etc.
  

Student’s Name:	Date of Birth:	Grade:

Signature of Parent/Guardian: ______________________________________

Date: _________________________

Please Mail or Fax Records to:

Montessori School of Mauldin

205-B East Butler Rd.

Mauldin, SC 29662

Fax: [phone]

205 B. East Butler Road, Mauldin, South Carolina 29662 • 864.288.8613 • Fax: [phone] www.montessorischoolofmauldin.com

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