esignature | rfar


 

 

RELEASE FOR ACADEMIC RECORDS

You can also download the SJB Release for Academic Records Form here, and mail or deliver it to St. John the Baptist.

Additionally, you can email your completed document to Lucero Silva at lsilva@sjbcatholicschool.org.

 

LAST SCHOOL ATTENDED:  

City/State/Zip:  

Fax #:  

 

Student(s) Name/Birth Date/Grade:

 

  • Permanent Records
  • Behavioral Records
  • Immunization/Health Records
  • Special Education Records

 

I hereby request and permit the release and forwarding of all student records indicated above.  I understand my right to review these records. 

 

Signature:    Date:

 

Administrative Assistant

Lucero Silva

Leave this empty:

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Signature Certificate
Document name: esignature | rfar
lock iconUnique Document ID: fc282b524a1e8cb3e3919310da5582a48dd69789
Timestamp Audit
July 7, 2020 7:28 pm PDTesignature | rfar Uploaded by Lucero Silva - lsilva@sjbcatholicschool.org IP 24.20.22.127