The Family Educational Rights & Privacy Act (FERPA) can be deﬁned as: “A federal law designed to protect the privacy
of education records, to establish the right of students to inspect and review their education records, and to provide
guidelines for the correction of inaccurate and misleading data through informal and formal hearings.”
Oregon law prohibits EOU from giving anyone access to student information except with the student’s voluntary written
consent. EOU may release student information to individuals only with the written consent of the student – regardless
of the student’s age, or whether the student is a legal dependent of the individual, or whether the individual pays the
student’s tuition and school expenses. NOTE: FERPA does not permit information such as grades or GPA over the phone
or via e-mail, even to the student.
Student name (please print): Student ID#:
Authorized Recipient(s) of information:
(full name and relationship)
Oce of Financial Aid & Oce of Student Accounts
The Oce of Financial Aid and the Oce of Student Accounts are two separate oces. Filling out this portion of the
form will allow EOU to release information from both of these oces.
I hereby give my written consent to the Oce of Financial Aid and the Oce of Student Accounts to disclose the follow-
Any and all billing information
Any and all ﬁnancial aid information
Any and all scholarship information
For questions concerning your student loans or scholarships, please contact our Financial Aid Oce by calling toll free
800.452.8639 or 541.962.3550, or e-mail email@example.com.
For questions concerning billing information, please contact Student Accounts by calling toll free 800.452.8639 or
541.962.3590, or e-mail firstname.lastname@example.org.
NOTE: This does not permit any third party, such as a parent, to transact business on behalf of the student i.e. request-
ing a transcript.
I hereby give my written consent to the Registrar’s Oce to disclose the following information:
Any and all information pertaining to my academic record.
(initial here) (FERPA does not allow us to give information such as grades or GPA over the phone or via e-mail, even to the student.
For more information about FERPA, go to www2.ed.gov/policy/gen/guid/fpco/ferpa/student.html.)
For questions concerning your registration status, transcripts or grades, please contact the Registrar’s Oce by calling
toll free 800.452.8639 ext. 6 or 541.962.3519, or e-mail email@example.com.
Student signature: Date:
This release will remain in eect until you graduate, fall out of continuous enrollment, or revoke it in writing and deliver to: Eastern Oregon University, Attn: Registrar’s Oce, One University Blvd., La Grande, OR 97850. The above
information will not be released automatically; the authorized party must initiate a request. EOU is required to keep original signed consent forms. Students are advised to keep a copy of this form for their personal records.
Receipt date: Sta initials: Banner entry completed date: Sta initials:
EASTERN OREGON UNIVERSITY
Consent to Release Information
eou.edu/admissions | firstname.lastname@example.org | 541-962-3393