Office of the Registrar
Hepburn 214
Email: Registrar@njcu.edu
Website: https://www.njcu.edu/registrar
Phone: 201/200-3334
Fax: 201/200-2062
RELEASE OF INFORMATION FORM
____________________ ______________
Student’s Name Student ID Number
I grant New Jersey City University permission to release my education
record information (including grades and grade point average) to:
_______________________________my mother/father
________________________ ______________________
Student’s Signature Parent’s Signature
________________ __________________
Date Date
Revised 3/15
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