PERMISSION TO TRANSMIT INFORMATION
The Family
Educational Rights and Privacy Act (FERPA) prohibits
the transmittal of any “nondirectory” information about you without your
written consent. We would like to be
able to transmit information in response to appropriate requests that we may
receive. Information that would be
transmitted may include but not be limited to composite photos, grade point
averages and class rank for such items as honors, awards, and scholarship
opportunities, candidacy for membership in organizations, reduction for
insurance premiums and recommendations for various programs or other
opportunities. Parties that may
occasionally request information may include but not be limited to the <insert
parties here>, and an individual faculty member acting upon a
request made by you. In order to allow
us to transmit information, we are asking that you waive your rights under
FERPA to require written approval for each request that we may receive. If you understand and agree to these
conditions, please sign the waiver below and return it to <insert location, name, etc.>. This authorization will be in effect (unless
we are otherwise notified) until <insert parameter of time (indefinitely, until
otherwise notified in writing, etc.)>.
I, , do hereby waive my right
under
(please
print)
the
Family Educational Rights and Privacy Act to require my written approval to
transmit appropriate educational information for each request received.
Signature Date
Picture
Approval Form
0
Yes,
I agree to have my picture displayed on the CGT picture board and web site.
0
No,
I do not agree to have my picture displayed.
_______________________________________________
Signature
________________________________________________
Print Name
________________________________________________
Date
For more
information about FERPA, please go to