Fillable FERPA RELEASE FORM RECEIVED Student Informaon Oce of (University of Alaska - Fairbanks)

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FERPA RELEASE FORM RECEIVED Student Informaon Oce of (University of Alaska - Fairbanks)

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P___
FERPA RELEASE FORM
RECEIVED
Oce use only
SID label
Oce use only
I give permission to the University of Alaska to release the selected informaon to the recipient listed for the purpose of:
Government issued picture ID is required with this form.
If mailed or faxed, an enlarged copy of your ocial ID with a signature is required.
(i.e. providing access to parents, scholarship applicaon, reimbursement from employer or other source, etc.)
Last First Middle Inial UA ID No.
Mailing Address
City
State Zip
Phone No.
Email Address
Student Informaon
Types of Informaon to Release
All Records
Accounng Includes tuion and fee balances, nancial holds, mailing and billing address, payment plans, accounng
statements and collecons and debt informaon.
Admission Includes dates of applicaon, programs selected, documents received, documents pending, dates of admission,
admission status and condions of admission.
Registraon Includes current enrollment, dates of enrollment acvity, enrollment status, residency status, semesters aended
and mailing address informaon.
Academic Includes courses taken, grades received, GPA, academic progress, honors, transfer credit awarded and
Records degree(s) awarded.
Financial Aid Includes all general nancial aid informaon.
Page of
Release To
Release To
Release To
Release To
Cancel
Cancel
Cancel
Cancel
Check One:
Individual’s Name
Individual’s Name
Relaonship:
Releasee:
Relaonship to Student
Relaonship to Student
Relaonship to Student
Relaonship to Student
Student Signature Date
Authorizaon
ID Type
Veried By:
Date
Oce use only
Individual’s Name
Individual’s Name
Oce of Admissions and the Registrar
907-474-7500
admissions@uaf.edu • registrar@uaf.edu
Oce of the Bursar
907-474-7384
uaf-bursar@alaska.edu
Oce of Financial Aid
907-474-7256
nancialaid@uaf.edu
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General Informaon
The Family Educaonal Rights and Privacy Act (FERPA) deals specically with the educaon records of students,
aording them certain rights with respect to those records. For purposes of denion, educaon records are
those records which are
1) directly related to a student and
2) maintained by an instuon or a party acng for the instuon.
FERPA gives students who reach the age of 18, or who aend a postsecondary instuon, the right to inspect
and review their own educaon records. Furthermore, students have other rights including the right to request
amendment of records and to have some control over the disclosure of personally idenable informaon
from these records.
FERPA applies to all educaonal agencies and instuons that receive funding under most programs
administered by the Secretary of Educaon (34 C.F.R. 99.1). Almost all postsecondary instuons, both public
and private, generally receive such funding and must, therefore, comply with FERPA.
Under FERPA, students are given three primary rights. They have the right to: inspect and review their
educaon records; have some control over the disclosure of informaon from their educaon records; and
seek to amend incorrect educaon records.
Elecng FERPA Condenality
The university may release certain directory informaon to the public on a roune basis unless a student
requests, in wring, that the university not release it. Requests for non-disclosure remain in eect unl a
subsequent wrien request to release directory informaon is received.
Students who request non-disclosure of directory informaon
* Will not have name printed in the published university chancellor’s and dean’s lists or
commencement program.
* Will not have aendance and/or degree veried for employers, insurance companies, etc.
* Will only be able to discuss their UA Accounts in person with photo ID.
***PLEASE NOTE***
If you choose to elect the “condenality” opon for your educaonal records, informaon for you will
be withheld from a variety of sources, including: you - the student. This also includes friends, relaves,
prospecve employers, and the news media. Each student is advised to carefully consider the consequences
of a decision to elect “condenality”. Once elected the University cannot acknowledge the existence of, or
release informaon about, the record of any student who has elected condenality. (You can change this
elecon at any me -- see How to Elect FERPA Condenality at UAOnline.) No informaon or services will be
available to you via telephone if you have elected the condenality opon. Your only opons for conducng
business transacons with the University would be in person, aer presenng a valid photo ID, or through
secure login on UA systems.
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FERPA RELEASE FORM RECEIVED Student Informaon Oce of (University of Alaska - Fairbanks)

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Completed 24 July 2020

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