Fillable Permission To Disclose Grades 01

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Permission To Disclose Grades 01

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Permission to Disclose Grades
I, ____________________________ (print student name), give my permission for
Bluegrass Community and Technical College (BCTC) to disclose my grade records to the
high school I attend, ____________________________ (print school name). BCTC may
send the final grade report to the high school after the completion of each semester.
Student ID (Social Security # or Student ID#) _____________________
_________________________________ ______________________
Student Signature Date
Please return this form to:
Rebecca Simms
Director of Dual Credit Initiatives & Opportunity College
Bluegrass Community & Technical College
164 Opportunity Way
Lexington, KY 40511-2623
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Permission To Disclose Grades 01

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Completed 3 March 2020

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