REQUEST FOR HEARING ON CORRECTION OF EDUCATION RECORDS
To: Address:
Building Principal
I believe certain official student records of my child, , (Full Legal Name of Student) (School Name)
are inaccurate, misleading or in violation of privacy or other rights of my child.
The official education records which I believe are inaccurate, misleading or in violation of the privacy or other rights of my child are:
The reason I believe such records are inaccurate, misleading or in violation of the privacy or other rights of my child is:
My relationship to the child is:
I understand that I will be notified in writing of the time and place of the hearing; that I will be notified in writing of the decision; and I have the right to appeal the decision by so notifying the hearing officer in writing within ten days after my receipt of the decision or a right to place a statement in my child’s record stating I disagree with the decision and why.
(Signature)
Date: Phone #
Address:
City:
State: Zip:
Date Board Adopted 10/12/1992
Date Board Reviewed 3/21/2022