Fillable Record Information Permission to Release Education (Cambridge College Massachusetts)

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Record Information Permission to Release Education (Cambridge College Massachusetts)

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The Record Information Permission to Release Education (Cambridge College Massachusetts) form is 1 page long and contains:

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  • 7 check-boxes
  • 18 other fields

Country of origin: US
File type: PDF

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Permission to Release Education
Record Information
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Phone: 617.873.0101
Fax: 617-242-0026
registrar@cambridgecollege.edu
Requested by (student)
Last name _________________________________________ First name _________________________________ Middle name _________________________
Release to (recipient)
Name __________________________________________________________________________________________________________________________________
Organization/School ______________________________________________________________________________________________________________________
Address ________________________________________________________________________________________________________________________________
City, state, zip ___________________________________________________________________________________________________________________________
Education record information to be released
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
Purpose of release
________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
Permission
I give permission for _________________________________________________ to release the specied information to the recipient listed above.
Submit completed and signed form to:
Registrar's Oce
Cambridge College
500 Rutherford Avenue
Boston, MA 02129
Or email to:
registrar@cambridgecollege.edu
Or fax to:
617.242.0026
rev. 9/1/20
Student Signature
on paper printout or electronic* _______________________________________
Date _____________________________________________________________
Student ID#________________________
Your Cambridge College Location
Boston
Lawrence
Springeld
Puerto Rico
Southern California
NEIB
Other_____________
Signature of Parent or Guardian (if student is under 18)
on paper printout or electronic* _______________________________________
Date _____________________________________________________________
*Please see electronic signature options on the Registrar's web page
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Record Information Permission to Release Education (Cambridge College Massachusetts)

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Completed 20 May 2021

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