_______________________ Public Schools
_______________________, Connecticut
I, ___________________________________________________________________
have hereby requested access to ____________________________________________
records for the following reasons:
_____________________________________________________________________
Said records will not be made available to any other person or persons without the specific written consent of (Parent-Student) _______________________________
DATED: ______________________________________________________________
CONSENT
I hereby consent that _____________________________________________________
have access to my child's (to my) records with the understanding that such records will not be released by him/her to other persons without my further consent.
DATED: ______________________________________________________________