Release of Records

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Name of Student: _______________________________

Date: ____________

Present School: _______________________________________

I give my permission for the transfer of copies of my child's records to the Greenfield Center School. The record should include copies of the following:

1. Transcripts of grades or evaluations.
2. Results of all standardized tests.
3. Individual Education Plan, if applicable.
4. Other information maintained in student's permanent record.

_______________________________
Parent Signature

_______________________________
Date

Send requested information to:
Admissions Office
Greenfield Center School
71 Montague City Road
Greenfield, MA 01301
(V) 413-773-1700
(F) 413-774-1135
http://www.centerschool.net