PDF Authorization release school records - Alameda County Bar ...
AUTHORIZATION OF RELEASE SCHOOL RECORDS I hereby authorize the release of records, documents, or other information concerning ________________________________, DOB: _________________to ____________________________, the named individual's attorney and/or his/her representative. This release covers all school records, including but not limited to, records pertaining to discipline, expulsions, suspensions, attendance, grades, transcripts, testing results and special education. I understand that _________________________ and his/her staff will regard as confidential and privileged any information thus released to them, and will use said information for the sole purpose of assisting me with the legal matters upon which I Have sought their advise and assistance. A copy of this Authorization shall be as valid as the original. This authorization is effective immediately and expires one year from the date below. Dated:__________________________________
Signature: ______________________________________
Print full name: ___________________________Relationship to student: __________________
Phone number: ________________________________
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