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506.1E4 Request for Hearing on Correction of Student Records

Code No. 5O6.1E4
 
 
REQUEST FOR HEARING ON CORRECTION OF STUDENT RECORDS
 
 
To: ______________________________________Address: __________________________
Board Secretary (Custodian)
 
I believe certain official student records of my child,______________________
 
_______________________________, (Full Legal Name of Student), Riverside Community School District, are inaccurate, misleading or in violation of privacy or other rights of my child.
 
The official education records which I believe are inaccurate, misleading or in violation of the privacy or other rights of my child are:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
The reason I believe such records are inaccurate, misleading or in violation of the privacy or other rights of my child is:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
 
My relationship to the child is:  _____________________________________________
 
 
I understand that I will be notified in writing of the time and place of the hearing; that I will be notified in writing of the decision; and I have the right to appeal the decision by so notifying the hearing officer in writing within ten days after my receipt of the decision.
 
      ___________________________________
(Signature)
 
Date:  ____________________________
Address:___________________________
City: _____________________________
State: ____________ZIP ____________
Phone Number: _____________________