FERPA Release Form
9/16/08 (rev. 02/19/2019 SAS)
2019-2020 Consent for Release of Student Information
Last Name First Name SSN/SID
In accordance with the Federal Education Rights and Privacy Act, (FERPA), I authorize the release of my
financial aid information and/or academic records to the individuals or organizations named below.
The Financial Aid Office and/or Student Records Office will not release student information without proper
identifiers. To be given information, third-parties must provide their password (as assigned below by the
student) AND the student’s Social Security Number (SSN) or Student ID Number (SID).
Last Name First Name Relationship Password
Financial Aid Information Only Academic Records Only Both
Last Name First Name Relationship Password
Financial Aid Information Only Academic Records Only Both
Last Name First Name Relationship Password
Financial Aid Information Only Academic Records Only Both
I agree to waive my rights under FERPA and allow those named above to
have access to my 2019-2020
financial aid and/or academic records. This release is effective as of this date through June 30, 2020.
I understand I may revoke this release earlier, by providing a written statement to the Financial Aid Office or
Student Records Office.
Student Signature* Date
*If this form is not returned in person by the student, a copy of the student's government issued photo ID with a legible signature must be
included. Government issued photo ID may include a Drivers License, State issued Identification Card or Military Identification Card.