K-12 APPLICATION FOR ADMISSION / 2012-2013 - Chadwick School

Release of School RecordsTeacher evaluations, transcripts and records of standardized testing are a part of the application to Chadwick School.Please forward this completed form directly to your child’s current school.Current school____________________________________________________________________________________________________School address_______________________________________________________________________________________________________Street_______________________________________________________________________________________________________________City State Zip PhoneIn accordance with the Family Educational Rights and Privacy Act of 1974 and California State Law, I hereby authorize the release toChadwick School COPIES of all school records, including standardized test results, and any other developmental information regarding thepupil named below.Student’s name_____________________________________________________________________________________________________Last name First name Middle nameDate of birth__________________________________________________Current grade________________________________________(mo/day/yr)Signature of parent or guardian_______________________________________________________________________________________Print parent or guardian name_______________________________________________________________________________________Date______________________________________________TO THE PARENT:Please send a copy of your child’s final first semester grades by February 15, 2012.Chadwick SchoolOFFICE OF ADMISSION26800 S. Academy Dr.Palos Verdes Peninsula, CA 90274(310) 377-1543, ext. 4025www.chadwickschool.orgCHADWICK SCHOOL 9