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Get NAU Optional Authorization to Release Student Education Record Information 2017-2024

The Family Educational Rights and Privacy Act of 1974 as amended protects the privacy of education records establishes the rights of students to inspect and review their education records and provides guidelines for the correction of inaccurate or misleading data through informal and formal hearings. This Authorization applies to the disclosure of education records as defined on the Office of the Registrar website at http //nau. edu/registrar/ferpa/info/. The student choosing to release his or her educational records must complete and sign this form before Northern Arizona University can release specified information. I. Office of the Registrar 928-523-5490 Student Service Center PO Box 4050 Flagstaff AZ 86011 Fax 928-523-7330 ServiceCenter nau. Edu II. Recipient Information I authorize Northern Arizona University to release my educational records to the person s specified below Name s My educational records may be released upon written request by the listed person s bearing a signature via mail or fax to the Office of the Registrar see above. This Authorization applies to the disclosure of education records as defined on the Office of the Registrar website at http //nau. edu/registrar/ferpa/info/. The student choosing to release his or her educational records must complete and sign this form before Northern Arizona University can release specified information. I. Student Information Name of the Student Please print Address Box or Street City State Student ID Number Zip NAU Email Phone nau. Edu Optional Authorization to Release Student Education Record Information The purpose of this release is to facilitate the communication of student information to authorized individuals identified by the student. Generally this information will be released without student notification however the university reserves the right to notify students prior to the release of information. This release does not give authority to make changes to the student s educational record. The Family Educational Rights and Privacy Act of 1974 as amended protects the privacy of education records establishes the rights of students to inspect and review their education records and provides guidelines for the correction of inaccurate or misleading data through informal and formal hearings. Generally this information will be released without student notification however the university reserves the right to notify students prior to the release of information. This release does not give authority to make changes to the student s educational record. The Family Educational Rights and Privacy Act of 1974 as amended protects the privacy of education records establishes the rights of students to inspect and review their education records and provides guidelines for the correction of inaccurate or misleading data through informal and formal hearings. This Authorization applies to the disclosure of education records as defined on the Office of the Registrar website at http //nau. III. Consent The above information may be released with my full consent. I understand that this authorization remains in effect until my written revocation is received by the Office of the Registrar. Records which may be released All educational records including but not limited to Financial Aid Disciplinary Grades and Student Accounts. .

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