Fillable AUTHORIZATION TO RELEASE INFORMATION (NHTI – Concord's Community College)

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AUTHORIZATION TO RELEASE INFORMATION (NHTI – Concord's Community College)

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Registrar’s Office
31 College Drive, Concord, New Hampshire 03301
TEL: 603-230-4014 FAX: 603-230-9314 nhtiregistrar@ccsnh.edu
AUTHORIZATION TO RELEASE INFORMATION
The Family Education Rights and Privacy Act (FERPA) is a federal law which influences record
keeping in most colleges and universities. It is popularly known as the “Buckley Amendment”, and
the law requires that the educational records of students in colleges and universities receiving
Department of Education funds remain confidential. The Buckley Amendment allows others to
access a student’s educational records only if the student consents.
I
, (name of student, please print) (student ID or date of birth)
authorize access of my Academic information Financial information
To
:
(
name of recipient) (relationship)
(
name of recipient) (relationship)
This release of information does NOT allow access to the Student Information System (Student
Records via the Internet) or Official Transcripts.
(student signature) (date)
Changes to this form must be made in writing, by the student, to the Registrar’s Office.
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AUTHORIZATION TO RELEASE INFORMATION (NHTI Concord's Community College)

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Completed 13 August 2021

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