Plain Local Schools Registration
GlenOak High School
1801 Schneider St NE
Canton OH 44721
330-491-3800
Thank you for choosing Plain Local Schools for your child’s education.
Please complete the attached paperwork and provide the following documentation:
Certified Birth Certificate - we cannot use a copy
Proof of Residency - utility bill, rental agreement or purchase agreement
Copy of ETR and IEP if applicable Review is needed before scheduling classes
Copy of report card
Immunization Records
Custody Papers (when applicable)
When complete, please call the school (330-491-3800) to schedule an appointment to register.
8/08/14 Welcome Enrollment Info, page 1 of 1
FOR OFFICE USE ONLY:
Date request faxed or mailed: _____________________________
Date copies received: ___________________________________
PLAIN LOCAL SCHOOL DISTRICT [IRN: 049932]
Parent/Guardian/Student Consent for Records Release
TO Name of Last School Attended: REGARDING Name of Student:
_______________________________________ ________________________________________
ADDRESS STUDENT’S
of SCHOOL: ____________________________ BIRTHDATE: ____________________________
CITY/ST/ZIP: ____________________________ GRADE: ____________________________
The above named student has enrolled at GlenOak High School and we are requesting the following
information be sent to us:
*Grades in Progress *Health Record *Testing Data
*Report Card *Special Education Data *IEP/ETR
*Psychological Team Report *Transcript *Gifted Records
*ELL reports and test results *9
th
Grade Test Scores *Birth Certificate
Please send to:
With the understanding that the district cannot assume responsibility for the confidentiality of educational
information disclosed, I authorize you to release education information regarding the student named above, in
the manner indicated.
DATE: _____________________________ ____________________________________________
Signature of Parent
____________________________________________
Address
____________________________________________
City/State/Zip
NOTE: According to the Family Education Rights and Privacy Act [Buckely Amendment 99.31.P.L. 93-
380] dated 6/17/76, Vol.41 No. 118 Page 24673, parental permission is no longer required when records
are requested by authorized school personnel.
GLENOAK HIGH SCHOOL
Attn: Records
1801 Schneider Street NE
FAX: 330-491-3801
Phone: 330-491-3800
11/03/16 Request for Records, page 1 of 1