Request of Release Form

To: Parents/Guardians

SUBJECT: Students Transferring to Other Schools

Please complete the form below if:

You are moving to another school district or another State/Count
Your child will be enrolling in a Private School
Your child will be enrolling in another school because of an approved Geographic Exception.

No release will be required for those students who will be transferring to Honouliuli Middle School.

Please complete the form below. Required fields marked with an asterisk *

Student's First Name:*

Answer Required

Student's Last Name*

Answer Required

Current Grade*

Answer Required

Preschool

Kindergarten

1st

2nd

3rd

4th

5th

Date of Birth*

Answer Required

Last Day at Makakilo Elementary? (for those staying until the end of the year, the last day of class is 5/28)*

Answer Required

Reason you are requesting this form:*

Answer Required

Moved out of District

Private School

Moving to Mainland

Change in Military Station

Other:

Name of school your child will be attending:*

Answer Required

Address of new school:*

Answer Required

New School's Tel/Fax #:*

Answer Required

Student's New Home Address*

Answer Required

Student's New Home Phone #:

Number Required

I hereby provide Makakilo Elementary School with the information requested above and grant them permission to forward school repords for the above-named student to the Recieving School upon receipt of that school's Notice of Enrollment.

Parent Guardian Name:*

Answer Required

Today's Date:*

Answer Required

Relationship to Student*

Answer Required

Current Home #:

Number Required

Current Work #:

Number Required

Current Cell #:

Number Required

Email Address:

Answer Required

Please fix the highlighted areas below before submitting.

Request of Release Form