HCSD IRN#: 044107 REQUEST FOR SCHOOL RECORDS Student’s Name: ___________________________________________________________________________________ Last First Middle Date of Birth: ________________

Entering Grade: _______________

Start Date: ___________

Name of last school attended: ________________________________________________________________________ Address: _________________________________________________________________________________________ Phone:_________________________________

Fax:___________________________________

Please send Birth Certificate, Custody Papers, Education Record, Attendance, Immunization Records, Promotion/Retention Information, Transcript (with current grading scale), Current Grade Card with Withdrawal Grades, Intervention Reports, IEP, ETR, MFE to aid in present and future education decisions. Please note: Under the provisions of the Privacy Rights of Parents and Student Act, page 1213, Subpart D 99.30(B), it is not necessary to have the written consent of the parents to release records “to officials of other schools or school systems in which the student seeks or intends to enroll. . ..” Parent Signature (optional):__________________________________ SSID: _________________________________ The student above is: _____NOT EXPELLED from another school district at this time. _____EXPELLED from __________________________ School District at this time. The period of expulsion expires on_______________________________________. ______________________________________________ Official School District Signature/Title

______________ Date

Please send records to the following school:

Bridgeport Elementary 2171 Bridgeport Dr. Hamilton, OH 45013 PH:868-5580 Fx:868-5585

Brookwood Elementary 1325 Stahlheber Rd. Hamilton, OH 45013 PH:868-5590 Fx:868-5595

Crawfordwoods Elementary 2200 Hensley Ave. Hamilton, OH 45011 PH: 868-5600 Fx:868-5605

Fairwood Elementary 281 N. Fair Ave. Hamilton, OH 45011 PH: 868-5610 Fx: 868-5615

Highland Elementary 1125 Main St. Hamilton, OH 45013 PH: 868-5620 Fx: 868-5625

Linden Elementary 801 Hoadley Ave. Hamilton, OH 45015 PH: 868-5630 Fx:868-5639

Ridgeway Elementary 267 Wasserman Rd. Hamilton, OH 45013 PH:868-5640 Fx:868-5645

Riverview Elementary 250 Knightsbridge Dr. Hamilton, OH 45011 PH:868-5650 Fx:868-5655

Garfield Middle School 250 N. Fair Ave Hamilton, OH 45011 PH: 887-5035 Fx:887-4700

Wilson Middle School 714 Eaton Ave. Hamilton, OH 45013 PH: 887-5170 Fx:887-5186

Hamilton Freshman School 2260 NW Washington Blvd. Hamilton, OH 45013 PH: 896-3400 Fx:896-3402

Hamilton High School 1165 Eaton Ave. Hamilton, OH 45013 PH: 868-7700 Fx:887-4810

Hamilton City Schools - 533 Dayton St, Hamilton, OH 45013 - PH: 513-887-5000