Adopted: January 1978
Revised: October 2025
Please be advised that pursuant to your request dated ,
I have reviewed your challenge of certain information in the educational records of:
Student's name School
Home Address
Phone
The following is my determination:
Description of Information Challenged Denied/granted
1.
2.
3.
4.
5.
*If a request to amend records is granted, the amended records are attached to this form. If a request to amend student records is denied, you have the right to request a hearing pursuant to section 13 of Administrative Regulation 505.2AR, Protection and Privacy of Student Records. A copy of Administrative Regulation 505.2AR, Protection and Privacy of Student Records is attached.
Date Superintendent or designee