TRANSCRIPT THIRD PARTY
RELEASE FORM
STUDENT AUTHORIZATION FORM
To comply with FERPA regulations, Transcripts and Letters of Enrollment may only be released to the
student of record or another Educational Institution. To fulfill this request for Transcripts of Letter of
Enrollment, the student must acknowledge and authorize the release of his/her records to the third party
named below:
PLEASE COMPLETE THE INFORMATION BELOW, SIGN AND DATE
I, (print your first and last name) authorize Fresno City College, Reedley
College, and/or Clovis Community College to release my transcript or letter of enrollment to the third party
named below. In accordance with FERPA regulations, you may release my records.
LAST OR ORGANIZATION NAME:
FIRST NAME or DEPARTMENT:
STREET ADDRESS:
CITY, STATE, ZIP:
I understand that this form does NOT serve as a standing order and that I will need to submit a new form
each time I request the release of my records to a third party.
STUDENT’S SIGNATURE AND DATE:
STUDENT ID #:
click to sign
signature
click to edit
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