Student Consent of Release of Education Records

Upon signature below, I am giving my consent for the release of specific educational records maintained by the college under the provisions of the Family Educational Rights and Privacy Act of 1974 (FERPA), as amended. By submitting this form, I request that the following information from my educational records be released to the party designated below.

Please note:

This form will be submitted to the Office of the Registrar
This form will be kept on file for the student making the request
Transcripts received from other institutions can only be released as unofficial documents
Personal references/recommendations cannot be released

Name*

First Name

Middle Name

Last Name

Student ID number*

Student email address*

Birthdate*

This will be used to verify your identity before your submission is approved.

Last 4 digits of your SSN*

This will be used to verify your identity before your submission is approved.

Please choose one option:*

Standing release as long as I am enrolled at TMU Specific instance

Date for specific instance

Information to be released*

Name of person or organization to release the data to*

Preferred method of transmission*

Phone

Address

Address Line 1

Address Line 2

City

State

ZIP Code

Email

Fax

Signature*

[clear]

Use your mouse or finger to draw your signature above