Fillable Release Information to Parent/Spouse/Third Party (University of Michigan-Flint)

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Release Information to Parent/Spouse/Third Party (University of Michigan-Flint)

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Cashier’s & Student Accounts – Release Information Permission blank form – http://www.umflint.edu/studentaccounts/forms/release.pdf
Release Information to Parent/Spouse/Third Party
Student Name: __________________________________________________________
UMID: __________________________________________________________
I give UM-Flint Cashiers/Student Accounts permission to release information regarding
my student account to:
Parent: __________________________________________________________
__________________________________________________________
Spouse: __________________________________________________________
Third Party: __________________________________________________________
__________________________________________________________
_____ for current semester only
_____ for as long as I am a student
I understand that Cashiers/Student Accounts will only release information regarding my
student account record. This does not authorize them to discuss my academic records,
registration or financial aid.
Signed: __________________________________________________________
Student Signature
Date: __________________________________________________________
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Release Information to ParentSpouseThird Party (University of Michigan-Flint)

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Completed 4 February 2021

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