Revised 7/17/13 vse
PLEASE SIGN AND RETURN THIS FORM:
Georgia College & State University
Office of the Registrar
Campus Box 69
Milledgeville, GA 31061
firstname.lastname@example.org (478) 445-1914
The Family Educational Rights and Privacy Act (FERPA) is a Federal law designed to protect the privacy of a student’s education records. This Act prohibits
university officials from disclosing any records, including grade reports, academic standings, transcripts of records, or any other records, files,
documents, and materials in whatever medium, which contain information directly related to the student and from which the student can be individually
Georgia College & State University must have a signed acknowledgment from you before educational information can be released to a third party (i.e.,
parent, spouse, etc).
Please complete all items below and return this authorization form to the Office of the Registrar only if you want another party to have access to this
I hereby authorize Georgia College & State University to release information regarding my academic records to the individual named above in person.
Proper identification is required for access to records.