Fillable STUDENT CONSENT FORM Troy University, in accordance with (Troy University)

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STUDENT CONSENT FORM Troy University, in accordance with (Troy University)

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STUDENT CONSENT FORM
Troy University, in accordance with the Federal Family Educational Rights and Privacy Act (FERPA),
seeks to assure the highest levels of confidentiality regarding student records and information. Student
information will not be disclosed to a third party without the written consent of the student, unless
directed by law.
As a student, you are eligible to designate a parent, guardian, or spouse to whom appropriate
information can be released. By granting consent, you also grant the designee, access to your Trojan
Web Express account.
AUTHORIZATION TO RELEASE INFORMATION
I, _________________________________, am/will be a student at Troy University.
Print Name of Student
I hereby provide written authorization, as required under 20 USC 1232g (the Federal Family Education
Rights and Privacy Act), and any similar state law, for Troy University to release all appropriate
information and records to the designated third party listed below:
PERSON TO WHOM INFORMATION IS TO BE RELEASED
RELATIONSHIP TO YOU
_______________________________________ ____________ ________________
Signature of Student Date Student ID Number
NOTE TO THE DESIGNATED THIRD PARTY: Most of the information you will have questions
about related to a student account will be answered on Trojan Web Express. In order to access this
information you will need the student’s login and password. This should be provided by the student to
you. Regarding all telephone or email inquiries for information, you will be asked to provide the
student identification number before any information will be released.
NO RELEASE OF INFORMATION
Students not granting consent for the release of information and/or records must sign below.
I do not provide authorization to release information and records to a third party.
_______________________________________ ____________ ________________
Signature of Student Date Student ID Number
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STUDENT CONSENT FORM Troy University, in accordance with (Troy University)

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Completed 21 July 2020

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