GOOD SHEPHERD SCHOOL
2301 N. Stockwell Road
Evansville, IN 47715

Request to inspect and review Student Record:

NAME:_____________________________________________________

ADDRESS:__________________________________________________

AGE: ______________________________      GRADE:______________

I am requesting that I be granted access to review and to inspect my child’s school records; the specific records I wish to review are:

DATE: ______________ SIGNATURE: ___________________________
                                                                        (Parent or Legal Guardian)