I (We) request that :
(Name of School)
(Street Address)
(City)
(State)
(Zip)
(Phone)
(Country Code)
(City Code)
US residents enter '000' for Country and City codes
to release the complete school record of: (Candidate's Full Name)
to include, where applicable, secondary standardized test results; the secondary school activity record; any special record to include special education (A. learning disabled, B. emotionally disturbed) classification, if any, and reasons; testing or psycho-educational evaluations; resource room, IEP or learning support programs; and a transcript of courses, grades, and credits.
These records should be sent to:
Dean of Admissions
Valley Forge Military Academy & College
1001 Eagle Road, Medenbach Hall
Wayne, PA 19087-3695
I (We) hereby authorize and consent to the release of information and records bearing on my personal history, academic record to any authorized representative of Valley Forge Military Academy & College.
This authorization includes permission to obtain copies and abstracts of records and information regarding my background.
The information will be used to assist the Admissions committee relative to my application for enrollment at Valley Forge Military Academy & College.
This authorization is valid for a period of one year commencing on the date signed below. Upon request, a copy of this signed statement may be furnished to the school, doctor, reference or other person furnishing such information or record. Copies of this release may be substituted for the original.