Date received: _____________________ by whom: _________________
Family Education Rights and Privacy Act
APPLICANT:
Name __________________________________________________
Name/Type of Program Direct Exchange In-direct exchange
I am studying overseas during: Fall ______ Spring ______
Semester at Sea
Summer ______
Academi
c Year ______ - ______ Calendar Year______ - ______
Under the Family Educational Rights and Privacy Act of 1974 I understand I have the right to have access to letters of
recommendation written on my behalf.
I wish this letter to be written in confidence and hereby waive my rights of access to this letter.
I wish to retain my rights of access.
Applic
ant's Signature ___________________________________________ Date ____________________
Reference name: e-mail:
Reference name: e-mail: