Parent Copy of Student Documentation

Use this page to obtain copies of records from your student’s previous or current school that are needed by Pearson
Online and Blended Learning. Check ONLY the items needed and send the form to your student’s previous or
current school. You will need to pay any copying costs. Once you receive these records, forward them to Pearson
Online and Blended Learning using the submission instructions on the Document Cover Page. If you are unable to
obtain the necessary documents, contact the Academic Placement Advising team at 1-800-382-6010.

DO NOT RETURN THIS FORM TO PEARSON ONLINE AND BLENDED LEARNING.

Name of Student: Date:

Name of School:
Address of School:

To Whom It May Concern:

I am the parent and/or legal guardian of the above-named student. I am looking at educational options for my student and
would like a copy of the item(s) checked below:
Progress report or report card from current
marking period
End-of-year report card
UNOFFICIAL transcript
State or other standardized test scores
Gifted evaluation or designation letter
Most recent IEP, all IEP amendments, or formal
exit documentation
Most recent evaluation report(s) (May refer to
eligibility report, MET, psychological
assessment, or supporting evaluation)
504 plan and supporting documents

Please do not withdraw this student from your school on the basis of this request.

The records can be sent to my address or fax number below.

Signature of Parent/Legal Guardian:
Name: Phone Number: Fax Number:
Address:

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