To: ______________________________________________ Date: ___________________________
Parent/or Guardian
Street Address: _________________________________________________________________
City/State: ____________________________________________ ZIP: _______________
Please be notified that copies of the ____________________________ Community School District's official education records concerning ____________________________, (full legal name of student) have been transferred to:
________________________________________________________ __________________________
School District Name Address
upon the written statement that the student intends to enroll in said school system.
If you desire a copy of such records furnished, please check here _____ and return this form to the undersigned. A reasonable charge will be made for the copies.
If you believe such records transferred are inaccurate, misleading or otherwise in violation of the privacy or other rights of the student, you have the right to a hearing to challenge the contents of such records.
__________________________
(Name)
__________________________
(Title)
I.C. Iowa Code Description
Iowa Code § 22 Open Records
Iowa Code § 279.9B Directors - Powers and Duties - Reports to Juvenile Authorities
Iowa Code § 280.24 Drug & Alcohol Possession Reporting
Iowa Code § 280.25 Information Sharing
Iowa Code § 622.10 Evidence - Communications in Professional Confidence
I.A.C. Iowa Administrative Code Description
281 I.A.C. 12.3 Administration
281 I.A.C. 41 Special Education
U.S.C. - United States Code Description
20 U.S.C. § 1232g Education - FERPA
20 U.S.C. §1415 IDEA - Procedural Safeguards
C.F.R. - Code of Federal Regulations Description
34 C.F.R. Pt. 300 Education - Disabilities/Children/Assistance to States
34 C.F.R. Pt. 300.610 Education - Confidentiality
34 C.F.R. Pt. 99 Education - Family Rights and Privacy
Cross References Description
102 Equal Educational Opportunity
102-R(1) Equal Educational Opportunity - Grievance Procedure
102-E(1) Equal Educational Opportunity - Annual Notice of Nondiscrimination
102-E(2) Equal Educational Opportunity - Continuous Notice of Nondiscrimination
102-E(3) Equal Educational Opportunity - Notice of Section 504 Student and Parental Rights
102-E(4) Equal Educational Opportunity - Discrimination Complaint Form
102-E(5) Equal Educational Opportunity - Witness Disclosure Form
102-E(6) Equal Educational Opportunity - Disposition of Complaint Form
603.03 Special Education
604.11 Appropriate Use of Online Learning Platforms
605.08 Artificial Intelligence in the Educational Environment
605.08-R(1) Artificial Intelligence in the Educational Environment - Regulation
708 Care, Maintenance and Disposal of School District Records
Cross References Description
712 Technology and Data Security
712-R(1) Technology and Data Security - Security Requirements of Third- Party Vendors Regulation
804.06 Use of Recording Devices on School Property
804.06-R(1) Use of Recording Devices on School Property - Use of District Owned Recording Devices Regulation
901 Public Examination of School District Records
Approved: 9/20/2021, 9/16/2024, 11/17/2025, 9/16/2026
Reviewed: 8/19/2026
Revised: 8/19/2026
