Board Policies & Administrative Procedures

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Exhibit I: Authorization to Release Student Records

Exhibit 1 – Request for Student Records
Related Procedure:  3 – 18 Student Records
Effective Date:  2013 September 1

Request for Student Records

Date: _______________
Attn: Office of the Principal

Name/Address of Previous School:

________________________________________

________________________________________

________________________________________

Please forward the Cumulative Records, and all Confidential Files including psychological, behavioral, academic assessments and medical reports for the following student in accordance with Alberta Student Record Regulations for the Province of Alberta, Section 2(1) digitally or by paper if you are not yet digital with PASI.

Student Legal Name:   _______________________________________    

Student AKA Name:  _________________________________________

Student D.O.B.:   ___________________________________________    

Current Grade _______________________________________

ASN (Alberta Student Number if known):  _________________   

If no records are available, please call or fax the school to advise.

Thank you

Name and Address of Requesting School:

_____________________________________________

_____________________________________________

_____________________________________________

The collection of personal information herein is collected pursuant to the provisions of the Education Act and its Regulations.  The Freedom of Information and Protection of Privacy Act (FOIP) and the Vital Statistics Act, as the collection is related directly to and is necessary to the School Boards’ obligations to provide students with an education program that meets their needs and to provide a safe and secure school environment.  All information collected pertaining to students will be kept confidential unless otherwise authorized in writing by the parent or guardian of the student.