To print a copy of the request for school records, please click on link below:

 Request for records.pdf

 


REQUEST FOR STUDENT RECORDS

 

 

To: ______________________________________________________________________________________

 

Fax:______________________________________________________________________________________

 

The following student has enrolled in the Polo Community District effective:____________________________

 

_________________________________                   ___________                                   _____________

Name of Student                                                                 Grade                                                               Date of Birth

 

 

According to the Final Regulations-Family Educational Rights and Privacy Act dated June 17, 1976, it is no longer necessary to obtain written consent to release records between schools. It states that school officials, including teachers within the educational institution and officials of other schools in school systems in which the student may enroll, may receive a student's record without a written consent for such release. Please send the following information to:

 

Polo Community High School

Sheila Donmeyer, Counselor

100 Union Ave.

Polo   IL     61064

 

1.       A withdrawal date from your school.

 

2.       A complete transcript of courses and grades to the date of withdrawal.

 

3.       Progress, behavioral, health, and immunization records.

 

4.       Any other records deemed appropriate in determining the educational needs of the student. Please include the special education records, medical data, and psychological evaluation.

 

 

 

_______________________________________________                          __________________

                  Signature of School Contact Person                                                                   Phone

 

 

_______________________________________________                           __________________

            Signature of Parent/Guardian/Adult Student                                                           Date