• Special Education

    Authorization for Release of Records
    Special Education
  • This is an official request for a student's educational records. The information contained in this request should be considered private. Please complete all the information in full and then finalize your request by clicking 'Submit'.

    PLEASE NOTE: In accordance with the Family Educational Rights and Privacy Act of 1974 and California State Law, Sequoia Grove Charter Alliance will release to the school named below the student's records requested via this form.

  • Parents requesting copies of their student's records should email spedrecords@sequoiagrove.org   

     

    Thank you! 

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  •  - -
  •  - -
  • Educational Institute Authorization

  • I hereby certify and verify that the named student is requesting enrollment in our school and that my signature below authorizes Sequoia Grove Charter Alliance to forward the records for educational use only. I understand that the recipient of the record(s) will use said documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without the expressed written consent of the current/former student except under the authority of Public Law 93-380, Educational Rights and Privacy Act. By clicking 'SUBMIT', I certify this information as complete and accurate. I declare under penalty of perjury that the foregoing is true and correct.

  • Clear
  • Should be Empty: