Education Verification Request | Clark County School District Student Records

FOR LEGAL REQUESTS:

All Attorneys, legal entities and government agencies, please use this form to obtain former student educational records from the Clark County School District. (CCSD) Utilize the form below to order documents and submit ‘All’ subpoenas.

Please complete all information in full and then finalize the order process by clicking 'Proceed to Check Out'. The information required on this page is necessary to verify and protect your school record from being accessed by unauthorized individuals.

CCSD maintains student education records containing information directly related to the student. ‘Any and All’ records include academic records (all official transcripts, enrollment history) and confidential records (special education.)

Currently enrolled students at CCSD and their records are at the school site.

Middle school and high school students - school personnel are the custodian(s) of records for two years after the last date of enrollment.
Elementary school students - Student Record Services personnel become the custodian(s) of records immediately upon withdrawal from the district.

FOR CORPORATE REQUESTS:

This is an official request for a copy of a student record. The information contained in this request should be considered private. Please complete all information in full and then finalize the order process by clicking 'Proceed to Check Out'. The information required on this page is necessary to verify and protect your school record from being accessed by unauthorized individuals.

FOR ALL REQUESTS:

Former student's records - Student Record Services (SRS) maintains these records and archives them according to the retention laws of the state of Nevada.

You will receive emails from (scribonline@scribsoft.com) to notify you of the status of your order. It is important you read those emails carefully as additional information may be required to process your request. You will be notified of the delivery mechanism by email. Status can be checked via the 'Order Tracker'.

PLEASE NOTE: A signed release by the student is required for a High School Transcript unless you are a post-secondary institution. Education verifications do not require a signed release. The signed release may be uploaded via the Order Tracker.

For further questions about education records collection, call 702-799-2487 option #2.

Corporate Requestor Information:

Corporate Name: ^(legal)

Federal Tax ID:

Business Client Name:

Internal Tracking ID:

Contact Name:

Corporate Address:

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Corporate Telephone: ^{(###-###-####)}

^Primary:

^Cell:

Updates via Text Message?

Yes No

Email:

^Address:

^Confirm:

Please attach student authorization

Click here to complete later. I will upload the required government-issued identification and/or release documents to the Order Tracker. I understand that failure to complete this step will result in the cancellation of my order.

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Student's Name While Attending School:

Last Name: ^{(in school)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Last 4 SSN:

Last 4 SSN: ^(confirm)

Student ID:

Information Related To Student's Birth:

Date of Birth:

Current Age:

Student's Last Clark County School of Attendance:

Name of School :

Last Year Enrolled:

Did they graduate?

Yes No

Student Current Name:

Last Name: ^{(official id)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Student's Current Residence Address: ^{(this may be different than the mailing address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Student's Current Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Documents Will Be Delivered To: ^{please enter the delivery addresses}

	Name	Attention	Addr 1	Addr 2	City	State	Zip	Country	# of Copies

Special Instructions :

Reason(s) for Request of Student Record:

Education Employment Personal Other

Select The Information Type(s) Requested:

Affidavit Fee ^{( $10.00 ea. + $10.00 copy )} Enrollment History ^{( $6.00 ea. + $6.00 copy )} Any and all Records ^{( $35.00 ea. + $35.00 copy )} Confidential Records (Special Education) ^{( $20.00 ea. + $20.00 copy )} Latest Official Transcript ^{( $10.00 ea. + $10.00 copy )}

Total Fee:

AUTHORIZATION NOTIFICATION:

I hereby certify and verify that my corporation has expressed written consent to release information from the former student of Clark County School District for which this request is made. I understand that the recipient of the record(s) will use said documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other part or agency without the expressed written consent of the former student except under authority of Public Law 93-380, Educational Rights and Privacy Act. By clicking 'Proceed to Checkout', I certify this information as complete and accurate.

I have enclosed the correct fees and understand that they are nonrefundable. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.

Coupon Code:

Your Initials:

Pay by Money Order

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