506.01-E(4) - Request for Examination of Education Records

To: ______________________________________________________    Address:  _____________________________________

Board Secretary (Custodian)

 

The undersigned desires to examine the following official education records.

 

________________________________________________________________________________________________________

 

________________________________________________________________________________________________________

 

________________________________________________________________________________________________________

 

 

of _____________________________________________________ , _______________________________________________

(Full Legal Name of Student)                                                    (Date of Birth)                         (Grade)

 

________________________________________________________________________________________________________

(Name of School)

 

My relationship to the student is: _____________________________________________________________________________

 

(check one)

 

______ I do

______ I do not

 

desire a copy of such records. I understand that a reasonable charge may be made for the copies.

 

 

                                                                                                                        ______________________________________

(Parent's Signature)

 

 

 

 

 

APPROVED:                                                                                                    Date: _________________________________

 

Address: ______________________________

 

Signature: __________________________________________________             City: _________________________________

 

Title: ______________________________________________________             State: _______________ ZIP ______________

 

Dated: _____________________________________________________             Phone Number: _________________________

 

 

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  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
                                       
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
Reviewed: 10/20/2025
Revised: 10/20/2025