Student Consent to Release Education Records
The Family Educational Rights and Privacy Act of 1974, as amended, prohibits postsecondary educational institutions from disclosing the education
records of students to most third parties without the students' written consent. The parents of St. Thomas students are third parties under the
provisions of this federal law and university policy. Accordingly, the University of St. Thomas requires the written consent of its students prior to
disclosing most education records/information. The Office of Student Data & Registrar can provide information about exceptions.
This form is for the use of students who wish to voluntarily consent to the release of their education records to a third party. A student who wishes to
authorize the university to disclose their education records to a third party should complete this form and provide it to the Office of Student Data &
Registrar. A legible copy of the form is adequate consent. This form may be copied for personal records.
Third Party Information
First Name:
Last Name:
Organization Name:
Relationship:
The following records/information may be disclosed:
This consent is valid until (Date on which consent expires):
I understand and certify that:
1. This consent authorizes any university employee who is authorized to access these records (including faculty) to disclose the specified
records/information to the specified third party.
2. The university may disclose the specified records/information to the third party but is not required to do so. Disclosure is at the discretion of the
records custodian to whom the consent is provided. No precedent is established by the decision of any particular University of St. Thomas records
custodian to disclose or not disclose on any particular occasion.
3. The specified records will be provided by any means deemed appropriate by the authorized records custodian provided that the third party making
the request presents this completed consent form or a legible copy of it.
4. This consent does not authorize the university to disclose education records/information to the third party by telephone or by any means that
precludes the positive identification of that person as the third party listed and the person to whom the form was provided by the student.
5. The university is not required to keep records of disclosures made based on this consent nor is it obligated to notify the student of such disclosures.
6. With respect to the third party named, this consent overrides any order I have filed for the non-disclosure of directory information.
7. This consent remains in effect as long as an above-named third party is in possession of this form or until midnight of the expiration date set out
above.
8. I am not required by law or university policy to give this consent. This consent is voluntary.
St. Thomas ID:
Date:
Student Signature:
Student Printed Name:
By signing above, I hereby consent to the disclosure of the specified education records/information to the following third party upon their request.
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