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Special Education Records Request
Date
MM slash DD slash YYYY
Name
(Required)
First
Last
Grade
Birthdate
MM slash DD slash YYYY
Age
Please enter a number from
1
to
25
.
Homeroom Teacher
School Site
(Required)
Camp Erwin Owen
Central
CLC
Clctech
East Kern Community School
Redwood
West Kern Community School
Referring to:
AmeriCorps
Jobs Plus (Seniors only who are on track to graduate)
R12
School Counselor
Stay Focused
Other
I would like to meet with the counselor regarding:
Academic Questions (Credit Check or questions regarding transcripts, transition back to home school, etc)
Personal/Social Concerns (Attitude, behavior, personal home/health, peer relations)
Career/College Information (Career/College exploration, financial aid, applications)
Other
“The Kern County Superintendent of Schools Office prohibits discrimination, harassment, intimidation, and bullying based on actual or perceived ancestry, age, color, disability, gender, gender identity, gender expression, nationality, race or ethnicity, religion, sex, sexual orientation, marital or parental status or association with a person or a group with one or more of these actual or perceived characteristics”.
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