FERPA Authorization Change/Removal Request Form

FERPA Authorization Change/Removal Request Form

Please complete this form if you would like to change your authorization status or add/remove authorized people.
FERPA is a federal law that provides students with protections and privacy regarding their education records.

For more information about FERPA:
Name*

First NameLast Name
Trine Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Student ID Number*
Do you want us to be able to talk with anyone about your academic record (grades, graduation status, etc.)?*

YesNo
Who do you want us to be able to speak with? You can have up to 2 people on your authorization-- Please include their full name(s) below. *
Should be Empty: