COMMUNITY COLLEGE OF ALLEGHENY COUNTY
Allegheny Campus Boyce Campus North Campus South Campus
808 Ridge Avenue 595 Beatty Road 8701 Perry Highway 1750 Clairton Road
Pittsburgh, PA 15212 Monroeville, PA 15146 Pittsburgh, PA 15237 West Mifflin, PA 15122
Ph: 412.237.2589 Ph: 724.325.6602 Ph: 412.369.3656 Ph: 412.469.6241
FAX: 412.237.3171 FAX: 412.237.3173 FAX: 412.237.3175 FAX: 412.237.3177
Financial Aid Release of Information Form
FERPA/HEA—Release of Financial Records
Student Name:___________________________________ SSN/Student ID#___________________
I_____________________________________, hereby authorize the Department of Financial Aid
[print student’s name]
of Community College of Allegheny College to release my various records and personal information to
the Federal TRIO Program. I acknowledge that such information and records may include, but not
necessarily be limited to Financial Infomration including protected personal information (as defined by
FERPA*/HEA*).
By signing below, I hereby provide my permission for any and all pertinent information and/or records
to be released and/or shared accordingly.
Signature:______________________________________________ Date:_____________________
Student Signature
Date of Expiration:_______________________________________________ (by leaving blank information may be shared indefinitely)
*The Community College of Allegheny County is subject to the provisions of and complies with the Family Education Rights and Privacy Act of 1974 (―FERPA‖). A
statement of the college policy can be found in the student handbook and college catalog. FERPA defines an ―educational record‖ as ―those records, files, documents,
and other materials‖ that (1) ―contain information directly related to a student; “and (2) ―are maintained by an educational agency or institution or by a person acting
for such agency or institution.”
*HEA Higher Education Act (HEA) of 1965: For the official version of the law, we recommend visiting uscode.house.gov. Note that these versions may not show the
most recent updates; official codification of amendments to the Higher Education Act into the law is a process that takes some time.
Revised June 25, 2019
Notifications of nondiscrimination and contact information can be found at https://www.ccac.edu/nondiscrimination/
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