This letter authorizes a school to release educational or disciplinary records for examination by attorneys or the court.
Re: <name of employee whose records are being sought>
Date of Birth: <date of birth of employee>
Social Security Number: <social security number>
To: <registrar name>
<I/We> hereby authorize <name of party or parties to acquire employment records> or their agent or representative, to inspect, review and make copies, including photostatic copies, of all records indicating grades, attendance, participation in extra-curricular activities, and all other personal records pertaining to student <name of student> from the date of <his/her> first enrollment at <name of school> to the present date. Photostatic copies of this authorization will be considered as valid as the original.
If student is over the age of 18 years, use this signature block:,
Dated: _______________
_____________________________________
Student signature
_____________________________________
Student name (please print)
If student is still a minor, use this signature block:
Dated: _______________
_____________________________________
Signature of parent or guardian
_____________________________________
Parent or guardian's name (please print)
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