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Authorization for Release of Student Information

Student's Namerequired
First Name
Last Name

Victor Central School District
953 High Street, Victor NY 14564
Attn: Carole Fenner, District Registrar Grades K-12
p: 585.924.3252 x1451
f: 585.742.7020
carole.fenner@victorschools.org

CSE Special Education Records please fax to CSE Office @ 585.742.7020

Grade 9-12 School Records - Fax directly to Kristin Stone @ 585.742.7043

Permission is given to release the following school records
Signature
Parent/Guardian's Namerequired
First Name
Last Name
Relationship to Student Please check one box
Please check one box
Must contain a date in M/D/YYYY format