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UNIVERSITY OF HAWAII CONSENT TO DISCLOSE EDUCATION RECORDS (University of Hawaii at Hilo)

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FERPA Form 7 (2013)
UNIVERSITY OF HAWAI‘I
CONSENT TO DISCLOSE EDUCATION RECORDS TO THIRD PARTY
I, _________________________________, ___________, ___________ hereby give my
(Full Name) (UH Number) (Birth Date)
consent to have my education records for the _______________ semester disclosed to the
following authorized individual: ___________________________________________.
Specific Records to be Disclosed:
Reason for Disclosure:
Third party must present a valid photo ID if appearing in person or must answer the
following security question in order to access information specified above.
Security Question:
Answer:
_________________________________________________ __________________
(Student’s Signature) (Date)
This request may be canceled at any time by the student. Requests to cancel must be
submitted in writing.
(This consent form is required by the Family Education Rights and Privacy Act of 1974.)
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UNIVERSITY OF HAWAII CONSENT TO DISCLOSE EDUCATION RECORDS (University of Hawaii at Hilo)

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Completed 29 August 2020

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