Name of Student *
Name of Student
Applying for Grade: *
Phone Number of School
Phone Number of School
Address of Previous School
Address of Previous School
Consent *
In accordance with the federal regulations regarding the privacy rights of parents and students under the Family Educational Privacy Act of 1974, the undersigned hereby consents to the release to Shoal Creek Adventist School of all the educational records (including statement of disciplinary action or disciplinary records) and other information as may be requested about the above named individual.
Parent/Guardian *
Parent/Guardian