To Whom It May Concern:



I, __________________________________________________, parent/legal guardian of


___________________________________________________ do hereby give permission to


release my child’s (children’s) permanent records to myself.


Please mail the complete record or copy thereof to:


_________________________________________ Name


_________________________________________ Home School Name (if you use one)


_________________________________________ Street or PO Box Address


_________________________________________ City, State, and Zip                               





Parent or Legal Guardian’s Signature                            Date



If you should have any questions or need additional information you may contact me at my home


telephone number, _____________________________________.



Thank you in advance for your kind assistance in this matter.





_________________________________(Parent or Legal Guardian’s Signature)