Crossroads Christian School
PO Box 295 / Crestview, Florida 32536 / 850-423-1291
Florida Department of Education #461480
Request For Student Records
Former School's Name:_______________________________________________
Address:____________________________________________________________
City:____________________________________ State: _______Zip:________
Phone Number:_______________________________
Name of Student:_____________________________________________
Date of Birth:_______________________________________________
Grade:___________________________
Please include:
| Up-to-date transcripts including dates of entry/withdrawal, grading scales, test scores, all subjects and grades to date of withdrawal (cumulative records). |
| Any psychological or special placement data. |
| Health records including physicals and immunization records or waivers as well as birth certificates. |
Please send records to:
Crossroads Christian School
PO Box 295
Crestview, Florida 32536
Parent Signature: _______________________________________________Date:___________
Registrar: _____________________________________________________Date:___________