THE CITY UNIVERSITY OF NEW YORK
FERPA RELEASE FORM
PERMISSION FOR ACCESS TO EDUCATIONAL RECORDS
This form allows students to grant third parties, including parents, access to their educational
records maintained by the student’s college. The Family Educational Rights and Privacy Act of
1974 (Buckley Amendment) prohibits access to, or release of, educational records or personally
identifiable information contained in such records (other than directory information) without the
written consent of the student, with certain regulatory exceptions. A description of a student’s
rights under FERPA is set forth in more detail in the college catalog.
Student Name (Please Print): _____________________________________________________
CUNYFirst EMPLD ID# or University Identification Number ___________________________
I, the undersigned, hereby authorize ________________ College of The City University of New
York, to release the following educational records and information (identify records or types of
records below):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
These records should be released to the following person/agency (identify name and address of
person/agency to receive information):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
These records are being released for the purpose stated below:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_______________________________ ___________________________________
Student’s signature Date
Please note that “directory information” can be given out without the student’s written consent.
The City University of New York defines directory information to include such information as a
student’s name, attendance dates, home and e-mail address, telephone number, date and place of
birth, photograph, status (e.g., full/part-time, undergraduate/graduate), degree program, credits
completed, major, student activities and sports, previous school attended, and degrees, honors
and awards received. This information may be released to anyone, unless restricted by written
authorization of the student. Contact the Registrar’s Office at your campus if you wish to restrict
this information.
CUNY Office of the General Counsel
February 2014