NOTIFICATION OF TRANSFER OF STUDENT RECORDS
To:
Date:
Parent/or Guardian
Street Address:
City/State
ZIP:
Please be notified that copies of the Chariton Community School District's official student records concerning , (full legal name of student) have been transferred to:
School District Name
Address
upon the written statement that the student intends to enroll in said school system.
If you desire a copy of such records furnished, please check here and return this form to the undersigned. A reasonable charge will be made for the copies.
If you believe such records transferred are inaccurate, misleading or otherwise in violation of the privacy or other rights of the student, you have the right to a hearing to challenge the contents of such records.
(Name)
(Title)