Montclair Public Schools
Student Registration Forms
Records Release Form
Student’s Name: ___________________________________________________________________________
Student ID: _______________________________________________________________________________
Address: _________________________________________________________________________________
State, Zip Code Montclair, NJ 07042
Date of Birth: ________________________________________________________
Grade: ______________________________________________________________
Name of Former School: ______________________________________________________________________________________
School Address, City, State, Zip Code: ___________________________________________________________________________
Has the student ever been referred to the Child Study Team? _______ Yes ____________ No
Records to be released (if they are available):
o Transcript of Grades
o Attendance Records
o Discipline Records
o PARCC Assessment Scores/High School Proficiency Test
o Child Study Team Records
o Original State Health Records and Appraisal Card and any
other medical information
o All other records that would assist with the educational
Please send the above items to: Montclair Public Schools
22 Valley Road
Montclair, NJ 07042
**In addition to the release of the above records to which you consent, we will be releasing the following mandated records for
which your consent is not required: transcript of grades, health records, and disciplinary records as per N. J. A.C. 6:3-6:5.