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.
