Rev. 04/06/2016
OFFICE OF THE REGISTRAR
MSC 105, 1050 W SANTA GERTRUDIS AVE
KINGSVILLE, TEXAS 78363-8202
PH (361) 593-2811 * FAX (361) 593-2195
www.tamuk.edu
FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT OF 1974 (FERPA)
AUTHORIZATION RELEASE FORM
● This form allows students to grant parents, guardians, spouses, and/or others access to their educational records maintained by the
Office of the Registrar, Business Office (Billing), Financial Aid Office and Dean of Students (Discipline Record).
● TAMUK maintains two types of student education records: directory information and other student records. Directory
information is considered public information and will be released by the University upon request, in accordance with existing
law.
● Any student who does not want directory information to be released, needs to place a check mark (√) in the box below.
Please read the information provided in the box prior to selecting this option.
● Please indicate your current preference for each category every time a change is made, to add or restrict information. NOTE: If
directory information has been restricted, then information will be released only to the parties designated below. Form is
not accepted by Fax or Email.
● I understand that this waivers my rights under FERPA of 1974. I also understand that this release will remain
active until I either appear in person or send a notarized statement to the Office of the Registrar at Texas A&M University-
Kingsville to deactivate it.
● I give permission for the following designee(s) to have access to all my academic records:
PLEASE PRINT CLEARLY (P=Parent, G=Guardian, S=Spouse, O=Other)
Release to Cancel Release ________________________________
Name
Release to Cancel Release ________________________________
Name
Release to Cancel Release ________________________________
Name
Relationship:
P G S O (Choose One)
Relationship:
P
G S O (Choose One)
Relationship:
P G S O (Choose One)
Security Password – Extremely Important! In order to ensure secure access to your records, we require the creation of a security
password that you share only with the designee(s) on this form. This information is critical in the event that the designee(s) contacts
TAMUK via a phone call or in person, and requires information from your records. If the authorized designee(s) correctly provides the
security answer then your records will be shared with your designee(s). However, the University reserves the right to deny access if
there is any doubt as to the authenticity of the person(s) requesting access. It may be necessary for the designee(s) to present a photo ID
and other documents in person in order to determine appropriate identification. For security purposes, email inquiries about your record
will not be accepted. It is required that you share your security answer with your designee(s)!
___________________________________________ K______________________ ________________
Print Name Student ID Number Date
___________________________________________ ________________________
Signature Security Password
Office of the Registrar’s Use Only: Processed by: _______________________________ Date: _____________________
□ Check (√) the box if you want your directory information to be confidential.
Pursuant to the “Family Education Rights and Privacy Act of 1974’ (FERPA), I request that my information classified as “directory information” be
withheld by the University from public disclosure. However, I understand this information may be provided to Texas A&M University-Kingsville
officials and other specified individuals as prescribed by FERPA. NOTE: Restricting certain directory information such as your name, program of
study, or degrees received may prohibit any release of information regarding your attendance at TAMUK. This could prevent you from being
recognized for awards, participating in commencement ceremonies, receiving enrollment verifications, etc.
