The Ivy Academy of Early Learning

Consent for release of student records


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Please check each item of Information listed below you wish to have released:

 

 


I authorize The Ivy Academy Inc. to obtain information concerning the above-named student from

 

 

 

 

 

 

NOTICE TO AGENT/PERSON RECEIVING RECORDS: Under the law, you are prohibited from allowing any other person access to any information from the student's record unless you obtain prior, written consent of the student's parent.

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Signature Certificate
Document name: Consent for release of student records
lock iconUnique Document ID: 66c2a149983b901db0638c2c98ce5a3e1d0fcaba
Timestamp Audit
October 11, 2017 8:26 am CDTConsent for release of student records Uploaded by Amy Hitchinson - ahitchinson@theivyacademy.org IP 77.99.32.61
February 20, 2018 10:53 am CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 165.225.80.244
February 20, 2018 10:53 am CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 165.225.80.244
February 20, 2018 10:54 am CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 165.225.80.244
August 29, 2018 2:46 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.231.184
August 29, 2018 2:46 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.231.184
August 29, 2018 2:46 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.231.184
December 13, 2019 5:40 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 13, 2019 5:40 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 13, 2019 5:40 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 13, 2019 5:40 pm CDTJeanette Mihalec - jmihalec@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 16, 2019 8:22 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 16, 2019 8:22 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 16, 2019 8:22 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 16, 2019 8:22 pm CDTJeanette Mihalec - jmihalec@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 8:06 am CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 8:06 am CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 8:06 am CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 8:06 am CDTJeanette Mihalec - jmihalec@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 8:06 am CDTAmy Hitchinson - ahitchinson@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
December 17, 2019 5:07 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 213.205.194.140
December 17, 2019 5:07 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 213.205.194.140
December 17, 2019 5:07 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 213.205.194.140
December 17, 2019 5:07 pm CDTJeanette Mihalec - jmihalec@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 213.205.194.140
April 30, 2020 7:38 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
April 30, 2020 7:38 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
April 30, 2020 7:38 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
April 30, 2020 7:38 pm CDTJeanette Mihalec - jmihalec@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
April 30, 2020 7:38 pm CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 86.21.181.23
February 14, 2021 4:34 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 14, 2021 4:34 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 14, 2021 4:34 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 14, 2021 4:34 pm CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 18, 2021 8:59 am CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 18, 2021 9:00 am CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 18, 2021 9:00 am CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 18, 2021 9:00 am CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 9:35 am CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 9:35 am CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 9:35 am CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 12:33 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 12:33 pm CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
February 27, 2021 12:33 pm CDTDil Ahdan - ivyenrollment@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
May 18, 2021 5:47 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
May 18, 2021 5:47 pm CDTReception Team - reception@theivyacademy.org added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
May 18, 2021 5:47 pm CDTDil Ahdan - ivyenrollment@1da.co added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
May 27, 2021 5:18 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
May 27, 2021 5:18 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
May 27, 2021 5:18 pm CDTDil Ahdan - ivyenrollment@1da.co added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
August 25, 2021 5:21 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
August 25, 2021 5:21 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
August 25, 2021 5:21 pm CDTDil Ahdan - ivyenrollment@1da.co added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
August 25, 2021 5:21 pm CDTDanielle Galvan - dgalvan@theivyacademy.org added by Amy Hitchinson - theivyacademy@ymail.com as a CC'd Recipient Ip: 77.99.32.61
September 20, 2022 5:36 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 18.217.59.22
September 20, 2022 5:36 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 18.217.59.22
September 20, 2022 5:36 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 18.217.59.22
September 20, 2022 5:36 pm CDTDanielle Galvan - dgalvan@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 18.217.59.22
September 1, 2023 11:01 am CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 1, 2023 11:01 am CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 1, 2023 11:01 am CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 1, 2023 11:01 am CDTJessica Rogers - jemerson@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 10, 2023 5:39 pm CDTLorena Delgado - ldelgado@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 10, 2023 5:39 pm CDTAmy Hitchinson - theivyacademy@ymail.com added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 10, 2023 5:39 pm CDTDil Ahdan - dil@1da.co added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 10, 2023 5:39 pm CDTJessica Rogers - jemerson@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
September 10, 2023 5:39 pm CDTKarina Cortez - kcortez@theivyacademy.org added by Amy Hitchinson - ahitchinson@theivyacademy.org as a CC'd Recipient Ip: 77.99.32.61
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