Name of Person Making Request* First Last Affiliation*ParentDCFCourt OfficerStudentHPS StaffOrganizationAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Release Location / Receiver*Student Information* First Name Last Name Grade Level (NUMERICAL VALUE) Student ID Date of Birth* MM DD YYYY Student's Current School*Adult EducationAsian Studies Academy at Bellizzi SchoolBatchelder SchoolBetances Early Reading Lab MagnetBetances STEM Magnet SchoolBreakthrough II Magnet (North) SchoolBreakthrough Magnet (South) SchoolBulkeley High SchoolBurns Latino Studies AcademyBurr SchoolCapital Community College MagnetCapital Preparatory MagnetClassical MagnetEnvironmental Sciences Magnet at Mary HookerExpeditionary Learning Academy at MoylanGlobal Communications AcademyGreat Path Academy at Manchester Community CollegeHartford Magnet Trinity College AcademyHartford Pre-K Magnet SchoolHigh School, Inc.HPHS Academy of Engineering & Green TechnologyHPHS Law and Government AcademyHPHS Nursing AcademyJournalism & Media Academy Magnet SchoolKennelly SchoolKinsella Magnet School of Performing ArtsM.D. Fox SchoolMaria Sanchez Elementary SchoolMartin Luther King, Jr. SchoolMcDonough Expeditionary Learning SchoolMilner Elementary SchoolMontessori Magnet at MoylanMontessori Magnet School at Annie Fisher SchoolNaylor SchoolNew VisionsParkville Community SchoolPathways Academy of Technology & DesignRawson SchoolRenzulli Gifted & Talented AcademySAND SchoolSimpson-Waverly SchoolSport & Medical Sciences AcademySTEM Magnet School at Annie FisherUniversity High MagnetWeaver - Culinary Arts AcademyWebster MicroSociety Magnet SchoolWest Middle SchoolWish Museum SchoolType of Record(s) Requested*Select all that apply. All (Includes everything listed below) Cumulative Record Attendance Record Report Card Disciplinary Record Pupil Services Record IEP/504 Evaluations Course Schedule(s) State Test Results Nursing Record(s) (Including immunization) Transcripts of Earned Credits (Fee Applies) Progress Monitoring Data Student Success Plan Other OtherPlease specify the record requested.Additional Information / NotesFileAccording to Board policy, for the records of regular education students, the board will make records available for inspection and review by parents or eligible students within a reasonable period of time, but in any event, no more than 45 days from receipt of a written request (via website request). According to Board policy for the records of special education students, the following time frames apply: As required by Section 10-76d-1 8(b)(l) of the Regulations of Connecticut State Agencies, written requests by parents of students requiring special education and related services will be accommodated within ten (10) school days of the receipt of such requests, within three (3) school days of the receipt of such requests if the requests are made in order to prepare for a meeting regarding an individualized education program or within three (3) calendar days of such a request if the request is made in order to prepare for a meeting related to any due process proceeding. One free copy of a student’s record will be provided to parents of students requiring special education and related services via written/ web request within 5 school days of the request.