California > Judicial Council > Juvenile
Consent To Release Education Information JV-227 - California
| Consent To Release Education Information Form. This is a California form and can be used in Juvenile Judicial Council . |
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JV-227 Consent to Release Education Information Fill in court name and street address: Superior Court of California, County of This form is used to consent to the release of education records of a child who is a subject of juvenile dependency proceedings to the child welfare agency to ensure that the child receives appropriate and effective services. This form also allows the agency to carry out case management responsibilities, to assist with Fill in child's name and date of birth: the transfer or enrollment of the child; and to inform the court of the child's Child's Name: educational needs. 1 I am a. b. c. d. e. 2 Date of Birth: The child's parent (my right to make education decisions about my child has not been terminated or limited by the court) The child's legal guardian (my right to make education decisions about the child has not been terminated or limited by the court) The child's educational representative appointed by the juvenile court A student 18 years of age or older who attends a postsecondary institution Indian custodian Case Number: Under the Family Educational Rights and Privacy Act of 1974 (FERPA) and California state law, I authorize (permit) any school, district, county office of education, or individual or entity maintaining the child's records to release these educational records to, and discuss them with (name of child welfare agency): These records include, but are not limited to, attendance, academic, individualized education program (IEP), medical, social, psychological, discipline, developmental, speech/language, and achievement test results. I request a copy of the records that will be released. This consent automatically ends one year from date of signature. This form is not intended to abrogate the rights of court-appointed counsel for the child to access records pursuant to Welfare and Institutions Code section 317(f) or court order. 3 4 5 Date: Type or print your name Sign your name Judicial Council of California, www.courts.ca.gov New January 1, 2013, Optional Form Consent to Release Education Information (Dependency) JV-227, Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com
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