KILLEEN INDEPENDENT SCHOOL DISTRICT
KILLEEN INDEPENDENT SCHOOL DISTRICT
Bellaire Elementary School
Records
108 West Jasper
Killeen, Texas 76542
Phone (254) 501-1412 or 1414
Fax (254) XXX-XXXX
Request For Records
DATE: __________________________
TO: __________________________
FAX: __________________________
FROM: __________________________
Total number of pages including cover sheet: ____
The Student(s) named below registered in the Killeen Independent School District for the year. To better assist us in scheduling and planning a program to benefit each student(s) educational goals, we request any and all school records for the student(s) named below, including:
____ A complete transcript through current level and transfer grades for current session
Elementary Students: Grades 1-5
Secondary Students: Grades 6-12
____ A copy of the most recent report card
____ Health records, Immunizations records, Birth Certificate and SSN card
____ Standardized Test Scores (Include TAKS for Texas schools)
____ An Interpretation of your grading system
____ Attendance and Disciplinary records
____ Entry and Withdrawal dates
____ Information concerning special programs (Special Ed, Bilingual, 504, Gifted)
Please send the records to the address above.
Last Name First Name MI Grade Date of Birth
Last Name First Name MI Grade Date of Birth
Last Name First Name MI Grade Date of Birth
I GIVE MY PERMISSION FOR ALL RECORDS OF THE CHILDREN LISTED ABOVE TO BE RELEASED TO THE REQUESTING CAMPUS.
Date Parental Release Signature KISD Representative Assigned Campus
KISD Form 285-708
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