National Paralegal College
STUDENT CONSENT FOR ACCESS TO EDUCATION RECORDS
OFFICE OF THE REGISTRAR
Name of Student (Last, First, Middle Initial):
Date:
The Family Educational Rights and Privacy Act (FERPA) afford certain rights to students concerning the privacy of,
and access to, their education records. Students may choose to complete and submit this form to the Registrar
allowing the release of their education records to specified third parties. Please note that while this form
authorizes NPC to release education records to third parties, it does not obligate NPC to do so. NPC reserves the
right to review and respond to requests for release of education records on a case-by-case basis. For additional
information, visit the U.S. Department of Education’s website at
www.ed.gov/policy/gen/guid/fpco/ferpa/index.html.
ELECTION A. Education records to be released (check all that apply):
Academic Information (grades/GPA, registration, student ID number, academic progress, enrollment
status)
Financial Aid Information (awards, application data, disbursements, eligibility, financial aid academic
progress status)
Loan Information (University-maintained loan disbursements, billing and repayment history [including
credit reporting history], communication history, balances, collection activity)
Student Account Information (billing statements, charges, credits, payments, past due amounts,
collection activity)
All Records Listed Above
Other (please specify):
SECTION B. Person(s) to whom access to education records may be provided:
Name(s) of person(s) and Relationship to Student to whom access to records may be provided (use additional
pages if necessary)
SECTION C. Duration of release (check one):
One-Time Use: This authorization can be used only once.
Limited Use: This authorization expires on:
SECTION D. Purpose of release (check one):
Family Communications
Employment
Admission to an Educational Institution
Other (please specify):
I understand that (1) I have the right not to consent to the release of my education records; (2) I have the right to
inspect any written records released pursuant to this Consent, and (3) I have the right to revoke this consent at any
time by delivering a written revocation to the NPC Registrar.
_________________________________________________________ ___________________
Student's Signature (Date) Signature of Parent or Guardian (if under 18) (Date)
