SHENENDEHOWA CENTRAL SCHOOLS

PARENT / GUARDIAN ACCESS REQUEST FORM

 
The Shenendehowa Central School District can provide access to student information via the Campus Portal.  In order to protect the confidentiality of student records, all parents/guardians who want to use this service are required to fill out this form and return it in person to any one of your student(s)’ schools.  For security purposes, a photo ID is required when you return the form.

PLEASE PRINT

 

Parent / Guardian

Name:  (one name per form)_____________________________________________________________

                                                                                (First Name, Middle Initial, Last Name)

Parent / Guardian

Home Address:  _______________________________________________________________________

 

Parent / Guardian E-Mail Address:  _______________________________________

 

Please list all children in household who are / will be enrolled in Shenendehowa Central Schools.

 

(Student Name)

 Your relationship to student

Reside with Student?

(Yes or No)

 

 School Grade Level
         
         
         
         
         

 

I certify that all of the above information is true and I have legal authority to access the records of the student(s) listed above.

 

Signed:___________________________________________                  Date: _____________________

                Signature & ID must be that of the Parent/Guardian shown on first line                   (mm/dd/yyyy)

 

Important – Once the information provided above is verified and processed, you will receive your Infinite Campus Activation Key via US Mail.  When you receive your Activation Key, you will be able to access the Campus Portal through Shenendehowa’s website:  www.shenet.org, and create your user name and password.  User name must be the first four letters of your last name, followed by the first four letters of your first name (i.e., Derek Jeter would be “jetedere”).  If your full name contains less than eight characters, use your full name (i.e., Ann Roy would be “royann”).  Your password must be alphanumeric, containing at least eight characters, two of which must be numeric, i.e., “yankee07”.

Office Use Only:

 

Date Returned:  ____________________       q ID Verified    Form & ID Checked By:__________________

 

q   Verify E-mail        q Activation Key Provided       Date Key Provided:____________     Initials: ______

 

Infinite Campus Parent Access Request – September 2007