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Record Release Form To the parent or guardian: Please sign and submit this release form to the appropriate school, program or specialist. Please send a second copy to TADS Admissions Management. This authorization also covers any conversation between GCE and representatives of the school, program or specialist. Student’s name: _______________________________________________________________________ Birth date: ____________________________ Grade applying to:

O 9th

O 10th

Gender: O Female O 11th

O Male

O 12th

I give ________________________________________________________________________________ permission to release the following sets of records to Global Citizenship Experience Chicago High School as a required piece of their admission process. Parent/guardian name (printed) __________________________________________________________ Parent/guardian signature _______________________________________________________________ Date _______________ o o o o o o

GCE’s Administrator/Counselor/Teacher/Coach Evaluations Report cards/progress reports for the past three academic years Teacher narratives for the past three academic years Standardized testing results from the past three academic years Psychological/educational evaluations and recommendations Tutor reports and/or recommendations

To the school, program or specialist receiving this release and request for records: Please send the requested information to TADS Admissions Management by mail or fax by February 1, 2011 or as soon as possible. We appreciate your efforts in helping complete this student’s admission file. Thank you.

TADS Admissions Management 1201 Hawthorne Ave., Ste. 100 Minneapolis, MN 55403 Fax: 612.548.3326


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