Editing previous response:

Please fix the highlighted areas below before submitting.

Request for Student Records

Please complete the form below. Required fields marked with an asterisk *

Please send all pertinent records, which include results of group tests, and all health/medical records and reports, attendance and academic data as well as grades to date of leaving your school.  If the student(s) qualifies for special education or any other programs, please send all information including psychological evaluations, speech and language evaluations, special education programs, including IEP's and other information of a confidential nature.

I certify that the above information is accurate*
Answer Required
Signature Required

Sign this form

By pressing “Sign Form,” you are agreeing to signing this form electronically.
Signature *
Type to sign
Draw your signature

Please release records to:
Ipswich Public School
PO Box 306
Ipswich, SD  57451
Confirmation Email