Third-Party Request for Unofficial Records Form

Third-Party Information:

Student Information:

School Information:

Choose From Drop Down MenuA. B. Lucas Secondary SchoolA. J. Baker Public SchoolAberdeen Public SchoolAdelaide-W. G. MacDonald P.S.Adult and Con Ed Tillson AveAdult Learning CentreAldborough Public SchoolAlgonquin Public SchoolAnnandale HighAnnandale Public SchoolArthur Ford Public SchoolArthur Stringer Public SchoolArthur Voaden Secondary SchoolAshley Oaks Public SchoolB. Davison Secondary SchoolBalaclava Street Public SchoolBeachville Public SchoolBiddulph Public SchoolBlenheim District Public SchoolBlossom Park Education CentreBonaventure Meadows Public SchoolBrick Street Public SchoolBroadway Public SchoolByron Northview Public SchoolByron Somerset Public SchoolByron Southwood Public SchoolC.C. 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McEachren Public SchoolMadeline Hardy SchoolManor & Highland Park Public SchoolMaple Lane Public SchoolMary Bucke Public SchoolMary Wright Public SchoolMasonville Public SchoolMcGillivray Central Public SchoolMcGregor Public SchoolMedway High SchoolMetcalfe Central Public SchoolMitchell Hepburn Public SchoolMontcalm Secondary SchoolMosa Central Public SchoolMountsfield Public SchoolMyrtle Street Public SchoolNew Belmont PSNew Sarum Public SchoolNicholas Wilson Public SchoolNorth Meadows Public SchoolNorth Middlesex District High SchoolNorth Norwich Public SchoolNorthbrae Public SchoolNorthdale Central Public SchoolNorthdale Public SchoolNorthdale Public School (East)Northridge Public SchoolNorthwest Public SchoolNorwich District High SchoolNorwich Public SchoolOakridge Secondary SchoolOld North Public SchoolOliver Stephens Public SchoolOrchard Park Public SchoolOtterville Public SchoolOxbow Public SchoolParkhill-West Williams Public SchoolParkside Collegiate InstituteParkview Public SchoolPierre Elliott Trudeau F.I. P.S.Plattsville & District Public SchoolPlover Mills Public SchoolPort Burwell Public SchoolPrince Andrew Public SchoolPrince Charles Public SchoolPrincess Anne French ImmersionPrincess Elizabeth Public SchoolPrincess Elizabeth Public School (East)Princeton Central Public SchoolRemote Elementary French ImmersionRemote Learning Elementary Public SchoolRemote Learning Grade 1 and 2Remote Learning Grade 3 and 4Remote Learning Grade 5 and 6Remote Learning Grade 7 and 8Remote Learning KindergartenRemote Learning Secondary SchoolRick Hansen Public SchoolRiver Heights Public SchoolRiverside Public SchoolRoch Carrier French Immersion Public SchoolRolph Street Public SchoolRoyal Roads Public SchoolSaunders Secondary SchoolScott Street Public SchoolSherwood Forest Public SchoolSir Arthur Currie Public SchoolSir Frederick Banting Secondary SchoolSir George Etienne Cartier Public SchoolSir George Ross Secondary SchoolSir Isaac Brock Public SchoolSir John A. Macdonald Public SchoolSir Wilfrid Laurier Secondary SchoolSir Winston Churchill Public SchoolSouth Dorchester Public SchoolSouth Ridge Public SchoolSouthdale Public SchoolSouthside Public SchoolSouthwold Public SchoolSparta Public SchoolSpringbank Public SchoolSpringfield Public SchoolSt. George's Public SchoolStoney Creek Public SchoolStoneybrook Public SchoolStraffordville Public SchoolStrathroy District Collegiate InstituteSummers' Corners Public SchoolSummerside Public SchoolSweaburg Public SchoolTavistock Public SchoolTecumseh Public SchoolThames Secondary SchoolThames Valley Alternative Secondary SchoolThamesford Public SchoolTollgate Central Public SchoolTrafalgar Public SchoolTurtle Island Public SchoolTweedsmuir Public SchoolUniversity Heights Public SchoolValleyview Public SchoolVictoria Public SchoolVictoria Public School (East)Victory Memorial Public SchoolW. D. Sutton ElementaryW. D. Sutton SecondaryW. Sherwood Fox Public SchoolW.D. 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Records Request Information: *

Unofficial Transcript Graduation Summary/Credit Counselling Summary

Attachment:

Attach the signed and dated Consent to Release document here.
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Attestation:

I certify that all information submitted on this form is accurate and I understand that the information provided to me must be used only for the purpose for which it is being requested.

Records Information: All third-party requests are processed in digital format and sent to the third-party contact via encrypted pdf document to the email address provided on this form.

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Notice of Collection: The information provided on this form is collected by the Thames Valley District School Board under the authority of the Education Act and Regulations (R.S.O. 1990 c.E.2) as amended and in accordance with the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). The information will be used to process your request and, where authorized, to disclose student information or records to you. Information is shared with employees such that they may carry out their job duties. In addition, the information may be used or disclosed to comply with legislation, for compelling circumstances affecting health and safety or discipline, as required in circumstances related to law enforcement matters, or in accordance with any other Act. For questions about this collection, contact the TVDSB Privacy Office, Thames Valley District School Board, 1250 Dundas Street, London, Ontario, N6A 5L1, Telephone: 519-452-2000, Email: privacy@tvdsb.ca.

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