WP E-Signature by Approve Me - Sign Documents Using WordPress -

Information Disclosure Release Form

Family Education Rights and Privacy Act (FERPA)_ Information Disclosure Release Form

FERPA, the Family Education Rights and Privacy Act, is a Federal Law protecting the privacy of student educational records. Schools must have written permission from a student before releasing non-directory information such as academic or financial records to other parties.

By signing this document, I am giving or revoking my consent for Woodmont College officials to discuss the contents of my academic record, including coursework and grades, and/or financial record, with the following parties. I understand I may revoke consent at any time by submitting this form.

Student Name:

I am access to my records to:

Testing and Training International Personnel, on a need-to-know basis

TAL Personnel, on a need-to-know basis

Parents

Academic Records:

Grant Consent

Revoke Consent

Financial Records:

Grant Consent

Revoke Consent

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

November 21, 2021 10:18 pm IST

Information Disclosure Release Form Uploaded by Rivka Levine - documents@woodmontcollege.edu IP 5.102.195.138

November 21, 2021 10:22 pm IST

Elisheva Steinhart - registrar@woodmontcollege.edu added by Rivka Levine - documents@woodmontcollege.edu as a CC'd Recipient Ip: 46.19.85.14

November 21, 2021 10:22 pm IST

Avital Lopiansky - applications@woodmontcollege.edu added by Rivka Levine - documents@woodmontcollege.edu as a CC'd Recipient Ip: 46.19.85.14

November 22, 2021 9:46 am IST

Elisheva Steinhart - registrar@woodmontcollege.edu added by Rivka Levine - documents@woodmontcollege.edu as a CC'd Recipient Ip: 5.102.195.138

November 22, 2021 9:46 am IST

Avital Lopiansky - applications@woodmontcollege.edu added by Rivka Levine - documents@woodmontcollege.edu as a CC'd Recipient Ip: 5.102.195.138

November 22, 2021 9:47 am IST

Avital Lopiansky - applications@woodmontcollege.edu added by Rivka Levine - documents@woodmontcollege.edu as a CC'd Recipient Ip: 5.102.195.138