Great Lakes Academy
46312 Woodward Ave. Pontiac, MI 48342 Phone: 248‑334‑6434 Fax: 248‑334‑6457
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Request for Educational Records

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FROM: Great Lakes Academy 46312 Woodward Avenue, Pontiac, MI 48342

RE: Please send the complete school records, including test scores, IEP and any other pertinent information that will assist us in enrolling the following student at Great Lakes Academy Public Charter School.

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Date of Birth*
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To request records for additional students, add names below.

Student Name
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Present Grade
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Date of Birth
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Input date as MM/DD/YYYY

Or select date from pop-up calendar
» click arrow to change month -- click year to change year


Student Name
Required Input

Present Grade
Required Input

Date of Birth
Required Input

Input date as MM/DD/YYYY

Or select date from pop-up calendar
» click arrow to change month -- click year to change year


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Parental permission is no longer required when records are requested by authorized school personnel. (Family Educational Rights and Privacy Act, Final Rule on Educational Records, Federal Register, June 17, 1976, Vol. 41, No. 118, Page 14673). Therefore, please furnish us with the following information in order to provide the proper placement of this student.

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