• General Education

    Authorization for Release of Student Records

  • This is an official request for a student's educational record.  The information contained in this request should be considered private.  Please complete all fields below then finalize by clicking "Submit".

    PLEASE NOTE:  In accordance with the Family Educational Rights and Privacy Act of 1974 and California State Law, Granite Mountain Charter School will only release the requested student's records to the school or parent/guardian named on this form.

  • I am a....*
  •  -
  • This Request is Coming From a:*


  • Student's Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Student's First Day of Enrollment with your School*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Please Release and Mail the Following Records*

  • Educational Institute Authorization

    I hereby certify and verify that the named student is requesting enrollment in our school and my signature below authorizes Granite Mountain Charter School to forward the requested records for educational use only. I understand the recipient of the record/s will use said document/s for legitimate interests only and the information contained therein shall not be further transferred or communicated to any other party or agency without the expressed, written consent of the current/former student except under the authority of Public Law 93-380, Educational Rights and Privacy Act. By clicking "Submit", I certify this information to be complete and accurate. I declare under penalty of perjury the foregoing is true and correct.

  • If you have any questions, please contact our Records Department. 

    Records@granitemountainschool.com

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