Authorization For The Release of Student Financial Aid Information
I, ______________________________________________, student # _________________________, hereby authorize The Fond du
Lac Tribal & Community College Financial Aid Office to release and/or orally discuss the Records described below about me to (list
organizations and persons, by name, that you wish us to share information with):
Family Member: _______________________________________ Family Member: ___________________________________
Organization: __________________________________________ Person: __________________________________________
Organization: __________________________________________ Person: __________________________________________
Organization: __________________________________________ Person: __________________________________________
The specific records covered by this release are Attendance, Grades, and Financial Aid Records.
I understand that the student records information listed above includes information which is classified as private on me under Minn.
Stat. § 13.32 and the Federal Family Education Rights and Privacy Act (FERPA). I understand that by signing this Informed Consent
Form, I am authorizing the Fond du Lac Tribal & Community College Financial Aid Office to release to the persons named above and
their representatives’ information which would otherwise be private and not accessible to them. I understand that without my
informed consent, the Fond du Lac Tribal & Community College Financial Aid Office could not release the information described
above because it is classified as private.
I understand that when my education records are released to the persons named above and their representatives, the Fond du Lac
Tribal & Community College Financial Aid Office has no control over the use the persons named above or their representatives make
of the records which are released.
I understand that, at my request, the Fond du Lac Tribal & Community College Financial Aid Office must provide me with a copy of
any educational records it releases to the persons named above pursuant to this consent. I understand that I am not legally
obligated to provide this information and that I may revoke this consent at any time. This consent expires upon completion of the
above stated purpose or after one year, whichever comes first. However, if the above-stated purpose is not fulfilled after one year, I
may renew this consent. A photocopy of this authorization may be used in the same manner and with the same effect as the original
I am giving this consent freely and voluntarily and I understand the consequences of my giving this consent.
_________________________________________________________ ________________________
Signature (must be signed in blue or black ink, not electronically) Date
An affirmative action, equal opportunity employer and educator. This document is available in alternative formats to individuals with disabilities. Consumers with
hearing or speech disabilities may contact us via their preferred Telecommunications Relay Service.        (July 30, 2019)
2101-14th Street Cloquet, MN 55720 | 218-879-0800 | | FAX: 218-879-0814
Family Educational Rights and Privacy Act (FERPA)
The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects
the privacy of student education records. The law applies to all schools that receive funds under an applicable program
of the U.S. Department of Education.
FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student
when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights
have transferred are "eligible students."
Parents or eligible students have the right to inspect and review the student's education records
maintained by the school. Schools are not required to provide copies of records unless, for reasons such
as great distance, it is impossible for parents or eligible students to review the records. Schools may
charge a fee for copies.
Parents or eligible students have the right to request that a school correct records which they believe to
be inaccurate or misleading. If the school decides not to amend the record, the parent or eligible
student then has the right to a formal hearing. After the hearing, if the school still decides not to amend
the record, the parent or eligible student has the right to place a statement with the record setting forth
his or her view about the contested information.
Generally, schools must have written permission from the parent or eligible student in order to release
any information from a student's education record. However, FERPA allows schools to disclose those
records, without consent, to the following parties or under the following conditions (34 CFR § 99.31):
o School officials with legitimate educational interest;
o Other schools to which a student is transferring;
o Specified officials for audit or evaluation purposes;
o Appropriate parties in connection with financial aid to a student;
o Organizations conducting certain studies for or on behalf of the school;
o Accrediting organizations;
o To comply with a judicial order or lawfully issued subpoena;
o Appropriate officials in cases of health and safety emergencies; and
o State and local authorities, within a juvenile justice system, pursuant to specific State law.
Schools may disclose, without consent, "directory" information such as a student's name, address, telephone number,
date and place of birth, honors and awards, and dates of attendance. However, schools must tell parents and eligible
students about directory information and allow parents and eligible students a reasonable amount of time to request
that the school not disclose directory information about them. Schools must notify parents and eligible students
annually of their rights under FERPA. The actual means of notification (special letter, inclusion in a PTA bulletin, student
handbook, or newspaper article) is left to the discretion of each school.
For additional information, you may call 1-800-USA-LEARN (1-800-872-5327) (voice). Individuals who use TDD may use
the Federal Relay Service ( Or you may contact us at the
following address:
Family Policy Compliance Office
U.S. Department of Education
400 Maryland Avenue. S.W.
Washington, D.C. 20202-4605