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<br /> <br />STUDENT TRANSFER FORM / <br />REQUEST FOR ONTARIO STUDENT RECORD (OSR) <br />(EXTERNAL TO THE OCDSB) <br /> <br /> <br />(R:PPR.539.SCO) <br />EFERENCE ROCEDURE <br />PART A: DEPARTING SCHOOL <br />This is to certify that: Student's Name Date of Birth OCDSB Home Room No. <br />Student ID No. <br /> <br />Student’s Address <br /> <br />Was in attendance at: School's Name School's Address <br /> <br />From To His/Her Present Placement Is <br /> <br />General Comments <br /> <br />Transferred to: School's Name School's Address <br /> <br /> <br /> ______________________________________ ________________________________________________ <br /> Date School Official <br />Your health unit may obtain health records from: <br />OTTAWA PUBLIC HEALTH <br />100 Constellation Crescent Ottawa, Ontario K2G 6J0 <br /> <br />The Ontario School Record Folder for this student will be forwarded directly to you upon receipt of this form <br />(completion of Part B) or alternatively, a request in the form of a letter on official letterhead. The parent/guardian, or <br />student, has been provided with a copy of his/her latest report card and Ontario Student Transcript, if applicable. <br />-------------------------------------------------------------------------------------------------------------------------------------------- <br />PART B: RECEIVING SCHOOL <br />CONFIRMATION OF REGISTRATION/OSR OFFICIAL REQUEST <br />This is to confirm that: Student's Name Student's Address Student's ID No. <br /> <br />Has registered at: School's Name School's Address <br /> <br /> <br /> ______________________________________ ________________________________________________ <br /> Date Parent/Guardian/Student Signature <br />I hereby agree to accept responsibility for the record and to use, maintain, transfer, and dispose of the record in <br />accordance with the Ministry of Education’s Ontario Student Record (OSR): Guideline, 2000 and the <br />Education Act. <br /> <br /> ______________________________________ ________________________________________________ <br /> Date School Official <br /> <br />Personal information on this form is collected under the authority of the Education Act and will be used for the purposes of a request for the <br />transfer of an OSR outside of the OCDSB. If you wish to review this information or have questions regarding its collection, please contact <br />the principal of the school where the student is registered. <br /> <br />OCDSB 539 School Operations (November 2009) Page 1 of 1 <br />