RECORDS RELEASE FORM - Crown Point Community School ...



CROWN POINT HIGH SCHOOL Please fax or email records: 1500 S Main St, Crown Point, IN 46307 Fax: 219.662.5662 ATTN: C. Ciciora, Registrar Ph: 219.663.4885 Ext. 11070 Email: cciciora@cps .k12.in.us ________________________________________________________________________________________ REQUEST FOR STUDENT RECORDS ENROLLMENT NOTIFICATION 599694013970 00 PLEASE FAX BEFORE Date of Request: _______________ Enrollment Appt:____________________________________________________________________________________ _________________ ___________________________ LAST, FIRST (Student) Cohort Date of Birth Please forward all of the items listed below along with other pertinent information that would assist us in meeting the educational needs of this student. INCLUDE YOUR CURRENT GRADING SCALE Undetermined grades may result in student placement testingTranscript Grades in progress ** Required for scheduling8th Grade Report Card (Final Semester Grades & Percentages)Test Score Reports; ACT, SAT, EXPLORE, ISTEP, PLAN, ECA Grades 6 - CurrentAttendance & Disciplinary Records (include weapon violations)Home Language Survey - INDIANA Schools OnlyHealth/immunization recordsCustody Documentation if applicable504 PlanPsychological testing informationEvaluation Reports I.E.P. – Special Needs Records ** Please include with transcriptENG Proficiency Documentation, Copy of Test Results ______________________________________________________________________________________ School _________________________________________________________________________________________________ Address City State Zip __________________________________________ __________________________________________ (area code) Telephone (area code) Fax Number ** Please forward to appropriate school if this reached you in error ** ................
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