FERPA Release Form

Manage the authorized handover of student records: the student indicates which records may be shared, with whom, and for which academic year, then confirms with a signature. Everything stays documented for the institution.

Use this template

In the Claude connectors directory

Page 1

Name of Institution releasing the records

Student Name

First Name

Last Name

Student Number

Date of Birth

Address

Street Address

City

State / Province

ZIP / Postal Code

Effective for this academic year:

Scope of consent

Please select the appropriate option:

Full consent Partial consent No consent

Records to be Released for Partial consent

Transcripts Attendance records Disciplinary records Financial aid records Health records

Page 2

Name of Recipient

Relationship to Student

Address

Street Address

City

State / Province

ZIP / Postal Code

Name of Recipient

Relationship to Student

Address

Street Address

City

State / Province

ZIP / Postal Code

Confirmation and signature

Student's Signature

Sign here

Date Signed

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