FERPA Waiver Name of Student: Last, First, Middle Initial
ECC I.D.
Date
The Family Educational Rights and Privacy Act (FERPA) of 1974 establishes the rights of students with regard to educational records. The act makes provision for inspection, review and amendment of educational records by the student and requires, in most instances, prior consent from the student for disclosure of such records to third parties. The consent must be in writing, signed and dated by the student, and must specify records to be released, reason for release, and the names of the parties to whom such records shall be released. The act applies to all persons formerly and currently enrolled at an educational institution. Access to educational records does not give permission to make changes to the student’s record. For more information for students, visit: http://www2.ed.gov/policy/gen/guid/fpco/ferpa/students.html For more information for parents, visit: http://www2.ed.gov/policy/gen/guid/fpco/ferpa/parents.html I, _______________________________________________, hereby, give permission for SUNY Erie Community College personnel to provide the following: all records of my progress degrees and/or certificates including graduation status course schedule including credit hours grades attendance including acceptance date financial aid information billing information and all information required for the processing of scholarship applications (WIA, TAA, WIB, etc.) and/or 599 Application during the period of which I am being considered or enrolled with and in need of services provided by these offices. Check one: This waiver will be in effect as long as I am a student at Erie Community College. This waiver will be in effect from: (Date)
until (Date)
I understand I can void or change this release in writing at any time. Person(s) to whom information (as checked above) may be released - Please PRINT clearly. Name (Last, First):
Relationship to student:
Name (Last, First):
Relationship to student:
I understand that all information will be treated as confidential and privileged, and used only for the purpose of monitoring my progress by the individual indicated above. Signature:
Date: