Holland Public Schools Request for School Records Date: Names of Children Grade Birthdate The student or students listed above are transferring from (please fill in the name of the last school attended) Name of School District School Name Street Address City, State & Zip School Phone Number School Fax Number Parent’s Permission: I hereby grant permission for the school listed above to transfer the records of my student(s) to the Holland Public school indicated below. Please send all records (academic test scores, cumulative record, health and immunization, special education records, test results and transcripts). Holland ECC East K-7 School Jefferson K-7 School th th 925 Central Avenue 373 East 24 Street 282 W. 30 Street Holland MI 49423 Holland MI 49423 Holland MI 49423 616-494-2650/Fax: (616) 393-7653 (616) 494-2425 / Fax: (616) 355-0674 (616) 494-2500 / Fax: (616) 393-7569 Holland Heights K-7 School West K-7 School Holland High School th th th th 856 East 12 Street 500 West 24 Street (8 – 12 ) Holland MI 49423 Holland MI 49423 600 Van Raalte Ave. (616) 494-2750 / Fax: (616) 393-7566 (616) 494-2350 / Fax: 616-393-7544 Holland MI 49423 (616) 494-2200 / Fax: (616) 394-2441 th th VR Tech (8 – 12 ) 461 Van Raalte Holland MI 49423 (616) 494-2600 / Fax: ((616) 393-7652 Date Signature of parent, guardian, or student 18 years or older Holland Public Schools does not discriminate on the basis of race, color, religion, sex, national origin, age, height, weight, marital status, handicap, disability or limited English proficiency in any of its programs or activities. Inquiries regarding the district’s nondiscrimination policies should be directed to: The Director of HR, Holland Public Schools, 156 W 11th Street, Holland, MI 49423. Phone: 626-494-2025.
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