Information Release Form

Download this form at www.liveoaksf.org

Parent: Fill out and submit the top part of this form to the student’s current or most recent school to allow the release of school records to Live Oak
School. Fill out and submit the bottom part to Live Oak School with your application. School: Submit student information to: Live Oak School:
1555 Mariposa Street, San Francisco, CA 94107. Telephone: (415) 861-8840 Fax: (415) 861-7153 Email: admissions@liveoaksf.org

I hereby authorize the school below to release information (evaluations, transcripts, report cards, etc.) regarding my child to Live Oak School
for the purpose of evaluating eligibility for admission.

Name of Student’s Current School _________________________________________________________________________________________________________________________________________

Name of Student _______________________________________________________________________________________________________________ Current Grade ____________________________

Student’s Address ____________________________________________________________________ City ___________________________________ State _________ Zip _________________________

Parent/Guardian Signature ___________________________________________________________________________________________________ Date ________________________________________

Information Release Form

Download this form at www.liveoaksf.org

Parent: Fill out and submit the top part of this form to the student’s current or most recent school to allow the release of school records to Live Oak
School. Fill out and submit the bottom part to Live Oak School with your application. School: Submit student information to: Live Oak School:
1555 Mariposa Street, San Francisco, CA 94107. Telephone: (415) 861-8840 Fax: (415) 861-7153 Email: admissions@liveoaksf.org

I hereby authorize the school below to release information (evaluations, transcripts, report cards, etc.) regarding my child to Live Oak School
for the purpose of evaluating eligibility for admission.

Name of Student’s Current School _________________________________________________________________________________________________________________________________________

Name of Student _______________________________________________________________________________________________________________ Current Grade ____________________________

Student’s Address ____________________________________________________________________ City ___________________________________ State _________ Zip _________________________

Parent/Guardian Signature ___________________________________________________________________________________________________ Date ________________________________________