FROM: RE:
Minot Public Schools Student Records Request
Date: _________________________________
Please Print: Student’s Last Name ___________________________________ First ___________________________Middle _____________________ Grade ______________ Date of Birth: ___________________
*** Name and Address of Previous School:
Phone & Fax of Previous School:
_________________________________________________________________
Phone: ( ) _______________________________
_________________________________________________________________
Fax: ( ) _______________________________
_________________________________________________________________
School Email Address: ______________________________________ Please release ALL student records to the SCHOOL MARKED BELOW, including:
* Transcripts
* Immunization Record
* Birth Certificate
* Standardized Testing
* 504 Plan
* Individual Education Plans (IEP)
* Cumulative Records (including withdrawal grades, attendance and discipline)
Elementary Schools -‐ Please Fax and mail records. Bel Air 501 25th St NW Minot, ND 58703 (Phone) 701-‐857-‐4590 (Fax) 701-‐857-‐8762 John Hoeven 3400 13th St SE Minot, ND 58701 (Phone) 701-‐418-‐1600 (Fax) 701-‐418-‐1669 North Plains 101 C St MAFB, ND 58704 (Phone) 701-‐727-‐3320 (Fax) 701-‐727-‐3328
OTHER _________________________________________________
Bell
Dakota
Edison
5901 Hwy 52 S Minot, ND 58701 (Phone) 701-‐420-‐1880 (Fax) 701-‐420-‐1870
101 Eagle Way MAFB, ND 58704 (Phone) 701-‐727-‐3310 (Fax) 701-‐727-‐3318
701 17th Ave SW Minot, ND 58701 (Phone) 701-‐857-‐4595 (Fax) 701-‐857-‐8752
Lewis and Clark
Longfellow
McKinley
2215 8th St NW Minot, ND 58703 (Phone) 701-‐857-‐4665 (Fax) 701-‐857-‐8757
600 16th St NW Minot, ND 58703 (Phone) 701-‐857-‐4610 (Fax) 701-‐857-‐8755
5 5th Ave NE Minot, ND 58703 (Phone) 701-‐857-‐4615 (Fax) 701-‐857-‐8756
Perkett
Roosevelt
Sunnyside
2000 5th Ave SW Minot, ND 58701 (Phone) 701-‐857-‐4680 (Fax) 701-‐857-‐8758
715 8th St. NE Minot, ND 58703 (Phone) 701-‐857-‐4685 (Fax) 701-‐857-‐8759
1000 5th Ave SE Minot, ND 58701 (Phone) 701-‐857-‐4690 (Fax) 701-‐857-‐8760
Washington
600 17th Ave SE Minot, ND 58701 (Phone) 701-‐857-‐4695 (Fax) 701-‐857-‐8761
Middle Schools – Please fax and mail records. Erik Ramstad 1215 36th Ave NW Minot, ND 58703 (Phone) 701-‐857-‐4466 (Fax) 701-‐857-‐4464
High Schools -‐ Please fax and mail records Central Campus 215 1st St SE Minot, ND 58701 (Phone) 701-‐857-‐4660 (Fax) 701-‐857-‐4636
Jim Hill
Memorial
1000 6th St SW Minot, ND 58701 (Phone) 701-‐857-‐4477 (Fax) 701-‐857-‐4479
1 Rocket Rd. MAFB, ND 58704 (Phone) 701-‐727-‐3300 (Fax) 701-‐727-‐3303
Magic City Campus Souris River Campus 1100 11th Ave SW 1510 University Ave W Minot, ND 58701 Minot, ND 58703 (Phone) 701-‐857-‐4500 (Phone) 701-‐857-‐4496 (Fax) 701-‐857-‐4521 (Fax) 701-‐857-‐4508
Parent/Guardian Signature ___________________________________________________________________________ Date: ___________________________ *Parental permission is no longer required when records are requested by authorized school personnel. (Family Education Rights and Privacy Act. Vol. 41, No. 11B, Page 24673)
***** Please fax ______ birth certificate ______ immunization record to: 701-‐857-‐4472, to complete enrollment packet
