FERPA Consent to Release Student Financial Information

FERPA Consent to Release Student Financial Information
Student Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Campus:*
Email Address:*
I authorize the release of financial information and records from my educational records to:
Name*

First NameLast Name
Last 4 digits of SS#:*
Relationship: *
Information to be released:*

Financial records and informationCommunications regarding financial records and resolutions of financial obligations
I acknowledge that this release is in effect until such time that I notify City College otherwise, in writing.
Signature:*

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Date:*
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