Fillable Privacy Waiver- Fillable (Antelope Valley College)

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Privacy Waiver- Fillable (Antelope Valley College)

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Antelope Valley Community College District
3041 West Avenue K, Lancaster, CA 93536-5426 | 661.722.6300 | www.avc.edu
Student’s Name: ______________________________________
Student’s I.D. Number: 900-_____________________________
PRIVACY WAIVER
In accordance with the Family Educational Rights and Privacy Act
(FERPA) of 1974, the following person/people have my permission to be
present in a meeting or telephone conversation where confidential
information about me may be discussed.
______________________ ______________________
______________________ ______________________
______________________ ______________________
______________________ Date: ________________
(Student’s Signature)
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Privacy Waiver- Fillable (Antelope Valley College)

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Completed 3 September 2020

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