Request for Electronic Access to MIS 4339

Grades and Attendance on the Parent Portal

Information Systems Department

School District of Okaloosa County
120 Lowery Place S.E.
Fort Walton Beach, FL 32548

School Name:______________________________________
Student Name Student ID#

Student’s Address Home Phone

Father’s Name Work Phone

Mother’s Name Work Phone

Student’s Email Address

Father’s Email Address

Mother’s Email Address

I request a password to access my student’s grades and attendance on the Internet.

Father’s Signature Date Mother’s Signature Date

You, as the parent or guardian, must return this form in person with a picture ID to the
school’s main office to obtain a password. If you reside out-of-county and are unable to
appear in person, please contact your child’s school to obtain the appropriate affidavit.

Parent/Guardian Signature Date

I hereby certify that the parent or guardian produced a

picture I.D. or an Affidavit of Identity is on file.

District Employee Signature

Date Issued Date Provided Password Assigned

Office Use Only