Return to List of Exhibits and Figures
Date: ________________________
From: [Name of Designated Official]
To: [Name of Parent(s)]
Your request for amendment of the education record of your child, ________________________, was received and reviewed.
______ The request was approved and necessary changes were made to the specified record as requested.
______ The request was denied because ________________________.
However, you are entitled to a hearing concerning your request. If you decide to request a hearing, please notify the following office within [number of days as specified by state or local policies].
[Name of Contact Person]
[Address and Telephone Number]
Signature: ________________________