WPS Records Request

WPS Records Request

This form can be used to request records FROM Woburn Public Schools for students transferring out of the district as well as records TO Woburn Public Schools for students entering the district. If you child is moving from one Woburn school to another (transferring within the district) this form does NOT need to be filled out.
Status

CompleteIn ProcessCancel
Request Type*

Entering Woburn SchoolsLeaving Woburn Schools
Status
1. Student First Name *
***Must EXACTLY match child's birth certificate***
2. Student Middle Name
***Must EXACTLY match child's birth certificate*** Leave blank if no middle name.
3. Student Last Name **
***Must EXACTLY match child's birth certificate***
4. Current Grade *
NOTE: Woburn does NOT need records for any incoming Preschool / Early Childhood Program or Kindergarten student.
5. Gender*

FemaleMaleNon-binary
6. Date of Birth *

MonthDayYear
Date

7. Records to be Released*

	Yes	No
(A) Cumulative Record Including Grading & Attendance
(B) Report Cards with current grade average and academic transcripts
(C) Standardized test scores
(D) Discipline Reports (mandatory at High School level)
(E) Immunization and health/medical records
(F) Medical/Mental Health
(G) Special placement records and reports (IEP’s)

New WPS Student
14. Prior School Name*
Enter the name of the school your child attended prior to enrolling in Woburn Public Schools.
15. Prior School Street Address
Enter the address of the school your child attended prior to enrolling in Woburn Public Schools.
16. Prior School City, State & Zip Code
17. Prior School Phone
Please enter a valid phone number.
18. Prior School Fax
Please enter a valid phone number.
19. Assigned Woburn School*

Exiting WPS
8A. Current Woburn School
What is the Woburn school that your child currently attends that you want records to be released from?
9. New School
Enter the name of the school that your child is transferring to in the space below. Woburn Public Schools will release / send records directly to the new school, not the household.
10. New School Street Address
11. New School City, State & Zip Code
12. New School Phone
Please enter a valid phone number.
13. New School Fax
Locate the school fax number from their website. Records are often faxed to schools.
All school issued materials including textbooks and Chromebook must be returned prior to records being released. Contact the school's main office to arrange drop off.*

I Understand

Parent / Legal Guardian Signature

I, the parent/legal guardian of the above named student, hereby authorize the above named school to release any of the listed school records to the indicated school. I further authorize this receiving person or agency to release to the personnel of the school district any or all information regarding the student which pertains to his /her educational, physical and social adjustment in school. I further understand that I may review the transferred records by making such a request of the principal and may also have all or any part of these records properly interpreted as necessary by appropriate school personnel.
20. Digital Signature
Please type your name below to confirm your request. A copy will be emailed to the email address provided.
21. Relationship to Student
If over 18 years of age, the student has the releasing authority.
22. Parent Email Address*
Required for identification purposes and to send a copy of this request for your records. If over 18 years of age, the student has the releasing authority.
23. Parent Phone*
Please enter a valid phone number.
Should be Empty:

New WPS Student