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Family Educational Rights and Privacy Act (FERPA) Release
Last Name: __________________________ First Name: ___________________________ Middle Initial: ___________ ID: ________________
The Family Educational Rights and Privacy Act of 1974, as amended, sets forth requirements regarding the privacy of student records.
FERPA governs the release of these educational records maintained by an educational institution and the access to these records.
Please see the Friends University Academic Catalog for the full University policy regarding FERPA.
Directory Information
Information that has been designated as directory information by the University may be released to outside entities upon request.
Friends University designates the following as directory information: name, address(es), email address(es), telephone number(s), dates
of attendance, major field(s) of study, awards and honors (including Dean’s List, etc.), degree(s) conferred (including dates), past and
present participation in officially recognized sports and activities, physical factors (heights/weights) of athletes and photographs.
Non-Directory Information
Information not included in the prior listing is considered by the University to be non-directory information. Students must consent to
the disclosure of non-directory information contained in the educational records, except to the extent that FERPA authorizes disclosure
without consent. That may include, but not be limited to, compliance with a legal request or in response to a health and safety concern.
Please consider very carefully the consequences of any decision made by you to release or withhold academic record information to
persons or organizations other than those authorized under FERPA. Regardless of the effects upon you, Friends University assumes no
liability for honoring your request. This form is valid until such time as you submit a request for change in writing.
Release of Educational Record Information
To request release of non-directory information, please indicate permission by checking yes or no in each category and signing at the
bottom of the page.
Financial Information
Parents
❑ Yes ❑ No Spouse ❑ Yes ❑ No Employer ❑ Yes ❑ No Other (must specify below) ❑ Yes ❑ No
Grades/Academic Record
Parents
❑ Yes ❑ No Spouse ❑ Yes ❑ No Employer ❑ Yes ❑ No Other (must specify below) ❑ Yes ❑ No
Names of people who have permission:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Password:
________________________________________________________________________________________________________________
Specify Other: ____________________________________________________________________________________________________________
Complete Non-Disclosure Request
If you’d like to request a complete non-disclosure of all information, please contact the Registrar’s Office at registrar@friends.edu for
guidance.
I have carefully read the above information and request my records be marked as I have indicated above.
Student Signature:
_______________________________________________________________________ Date: __________________________
FERPA Release
