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506.1E5 NOTIFICATION OF TRANSFER OF EDUCATION RECORDS

To:___________________________________                                 Date:__________________

                        Parent/or Guardian

 

Street Address:_________________________________________________________________

 

City:____________________________     State:__________________       Zip:_____________

 

 

Please be notified that copies of the Winfield-Mt. Union Community School District's official education records concerning                                         , (full legal name of student) have been transferred to:

 

District Name:__________________________________________________________     

 

Address:______________________________________________________________

 

 

 

upon the written statement that the student intends to enroll in said school system.

 

If you desire a copy of such records furnished, please check here            and return this form to the undersigned.  A reasonable charge will be made for the copies.

 

If you believe such records transferred are inaccurate, misleading or otherwise in violation of the privacy or other rights of the student, you have the right to a hearing to challenge the contents of such records.

 

 

________________________________________

                                                                                    Name

 

________________________________________

                                                                                                                   Title

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