Family Educational Rights and Privacy Act
Waiver of Privacy
The Family Educational Rights and Privacy Act of 1974 (PL93-380), commonly referred to as FERPA,
provides that all records pertaining to a student that are maintained by the College must be available for
inspection, review, and amendment by the student and requires, in most instances, prior consent from the
student for disclosure of such records to third parties. The consent to waive privacy at Tarrant County
College must be made in writing, signed and dated by the student, and must specify the names of the parties
to whom records will be released. The act applies to all persons formerly and currently enrolled at an
educational institution. No exclusion is made for non-U.S. citizen students. However, the act does not
apply to a person who has applied for admission, but who never actually enrolled in or attended the
institution or deceased persons. Meningitis vaccination records are protected by FERPA, and are not
subject to Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rules.
I hereby give permission for Tarrant County College personnel to provide information concerning all my
education records
to the person(s) identified below. This form must be completed in order for Tarrant
County College to comply with the request. Faxed requests cannot be accepted.
STUDENT INFORMATION
Name
Student ID Number
Street Address
City/State/Zip Code
Home Phone
Mobile Phone
E-Mail
Student Signature
PERSON(S) TO WHOM INFORMATION MAY
BE RELEASED
Name
Relationship to Student
Street Address
City/State/Zip Code
Home Phone
Mobile Phone
E-Mail
Tarrant County College is an Equal Opportunity/equal access institution.
Date
Save a trip to the Admissions & Registrar's Office by submitting the completed form from your myTCC e-mail account to one of the following:
northeast.registrar@tccd.edu | northwest.registrar@tccd.edu | south.registrar@tccd.edu | southeast.registrar@tccd.edu | trinity.registrar@tccd.edu
Waiver will be in effect for one calendar year from date of signature.
051519.KT
