FERPA Form: Consent for Release of Student Information

The Family Educational Rights and Privacy Act (FERPA) of 1974 is a federal law designed to protect the privacy of a student’s educational records. Educational records are considered confidential and will not be released without written consent from the student. In accordance with FERPA, it is necessary for Alaska Christian College to obtain written consent from a student in order to release any information. To do so the following declaration must be completed. This form, when completed, authorizes the person(s) below to view the student's education records.

Student Name (required)

Social Security Number - Last Four Only (required)

I, the above-named student, authorize representatives of Alaska Christian College to disclose information in my education records to the person(s) listed below. I understand that education records are all records maintained by the school, but I am only consenting release of the following: academic records, accounting records, financial aid records, and student discipline records. To the person(s) listed below.

First Authorized Person

Relationship to Student:

Second Authorized Person

Relationship to Student:

Third Authorized Person

Relationship to Student:

Check the box below if you would like to allow ACC to release your official transcripts when you're applying for scholarships.
I wish to allow ACC to release my official transcript.

Please Sign Below

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