Updated 1/2013
PERMISSION TO RELEASE STUDENT’S RECORDS
Student’s Name (please print):_____________________________________________________
Last First Middle
Student Number (Campus-Wide ID): __________________________
I permit Winthrop University to grant access to _______________________________________
(name and relation to student)
to view my (check as many as apply)
__Academic records
__Financial Aid records
__Financial records
__All of the above
Date: _________________ Signature: ____________________________________
This form will be used by Winthrop University campus offices to allow outside parties access to
a student’s grades, academic status, financial records, and/or financial aid records. This
permission form will be considered valid until the student graduates or by written request to
end this permission.
If you have questions regarding the status or purpose of this form, please contact the Office of
Records and Registration.
126 Tillman Hall, Rock Hill, SC 29733
Phone: 803.323.2194 Fax: 803.323.4600
recandreg@winthrop.edu
