Nigritian Academy
661.748.3278
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Requests for Student Records
To make a formal request for individual student records, please use the form below. If you need additional assistance, please contact the school office at (661) 748-3278 or send a support request to
[email protected]
.
Institution or Agency
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*
Indicates required field
Individual Requesting Records (ATTN)
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First
Last
Mailing Address
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Line 1
Line 2
City
State
Zip Code
Country
Contact Number
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Fax Number
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Email
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Type of Records Requested (check all that apply)
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Vital Records (unofficial copies only)
Immunization Records (unofficial copies only)
Verification of Enrollment and Attendance
Current Year Academic Records
Special Education Records
Secondary Transcripts (official)
Secondary Transcripts (unofficial)
Student Name
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First
Last
Former Name (if any)
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Date of Birth (MM/DD/YYYY)
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Year of Graduation (if known)
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School Identification Number (if known)
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Reason for Request
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Date of Request
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Method of Delivery (choose all that apply)
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Fax
Physical Mail
Electronic delivery (email attachment)
Electronic delivery (file transfer)
All methods of delivery are executed within 10 business days of the initial date of request.
Physical mail will be postmarked within 10 business days of the initial date of request.
For Fax requests, please include the Fax number in the contact field above.
For electronic file transfer requests, please include the link to the upload portal in the "Reason For Request" entry field above.
Authorization
My initials below constitute an electronic signature and authorizes Nigritian Academy to release information and / or student record(s) and confirms I have completed all sections accurately and truthfully, including information verifying my identity. If email delivery was selected above, I hereby authorize the Academy to transmit the records electronically via email and verify that I have provided an accurate email address to receive those documents electronically. I understand that the recipient of the record(s) will use the indicated document(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other party or agency without my expressed written consent except under authority of Public Law 93-380, Educational Rights and Privacy Act (FERPA). I declare under penalty of perjury that the foregoing is true and correct.
Initials
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Submit