Fillable FERPA Form (State University of New York College of Agriculture and Technology at Cobleskill)

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FERPA Form (State University of New York College of Agriculture and Technology at Cobleskill)

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U.S.A. forms for State University of New York College of Agriculture and Technology at Cobleskill

BROWSE STATE UNIVERSITY OF NEW YORK COLLEGE OF AGRICULTURE AND TECHNOLOGY AT COBLESKILL FORMS

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tudent Authorization:
NOTARY SEAL
FER
P
A
Student Records Access Authorization
Student Information
Student Name
Student ID
OR
Social Security # Phone Number
W
hat
is
Dir
ector
y
I
nf
or
m
atio
n?
Under the provisions of the Federal Family Education Rights and Privacy Act of 1974 (FERPA), Colleges may disclose information about a student
designated as “directory information.” This information can, by law, be released to the general public and may be listed in the campus directory. SUNY
Cobleskill has designated the following as Directory Information:
• Student Name
• Campus, local and home addresses
• Phone Number
• Major
• Department
• Dates of Attendance
• Dates of Graduation
• Degrees Awarded
• Awards
• Full-time/Part-time Status
• Date of Birth
• Email Address
• Photo/Video Footage
No other student information is released to non-university personnel without written permission.
In compliance with the federal Family Education Rights and Privacy Act of 1974 (FERPA), SUNY Cobleskill will not release non-directory student
information to a third party (including parents, spouses or corporate sponsors) without written consent of the student.
Access Granted To:
Name
Address
Email Phone Number
This individual may request and be provided the following information regarding my educational pursuit at SUNY Cobleskill:
□ Attendance
□ Class Participation
□ Class Work (tests,
quizzes, projects, etc.)
□ Final Grades *
□ Mid-term Grades *
Access Granted To:
Name
Address
Email Phone Number
This individual may request and be provided the following information regarding my educational pursuit at SUNY Cobleskill:
□ Attendance
□ Class Participation
□ Class Work (tests,
quizzes, projects, etc.)
□ Final Grades *
□ Mid-term Grades *
*
Mid-term and final grades are only available through Banner Web. An academic transcript may only be requested by the student.
Completed
forms
must
be
presented
in
person,
with
appropriate
identification,
or
mailed
to:
SUNY
Cobleskill, Office
of
the
Registrar, Knapp
Hall
101,
State
Route
7,
Cobleskill,
NY
12043.
Requests
received
by
mail
must
be
notarized
or
they
will
not
be
processed
.
Notary
Public’s
Signature
Date
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FERPA Form (State University of New York College of Agriculture and Technology at Cobleskill)

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Completed 24 July 2020

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