FERPA Notice Form

FERPA Notice Form
The Family Educational Rights and Privacy Act (FERPA) is a law that protects the data and records of the students and cannot be accessed by anyone without the student's consent. For more information about FERPA, kindly check this webpage: https://www.schoolname.edu/FERPA.
Do you grant permission for this school/college/university to discuss academic records during counseling?
Do you grant permission for this school/college/university to discuss academic records during online or live counseling using a third party video conferencing program with secured encryption?
Do you agree to provide accurate information like personal details, educational background, career goals, and other school related data to this school/college/university?
Do you understand that the purpose of FERPA is to protect your data and records as a student in this school/college/university?
Have you read the policy and the other terms and conditions of the school/college/university?
By signing or completing this form, you understand and agree to this policy and the terms and conditions of the school/college/university.
Student's Name
First NameLast Name
Student's ID
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date of Birth
MonthDayYear
Date
Student's Signature (optional)
Clear
Date Signed
MonthDayYear
Date
Should be Empty: