The Rising program

Seattle Public Schools: Authorization for Exchange of Information and Records

"*" indicates required fields


As a parent or guardian (adult student) you have the right to give permission or not give permission for the release of your child’s (your) records with other persons or agencies. This request provides you with the opportunity to approve or not approve such a request unless release of records is allowed under one of the exceptions under the rules implementing the federal Education Rights and Privacy Act (for example, transfer of records from one school district to another). It also provides you the opportunity to talk with the school district and ask for an explanation as to why the information is being requested and by whom.
Student Name*
School District: Seattle Public Schools

I hereby authorize the release of information & records

(Name of agency/person)
(Name of agency/person)
Parent/guardian/adult student signature*
By checking the field below, you agree to release this student's record(s)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.