TULANE UNIVERSITY
AUTHORIZATION FOR RELEASE OF INFORMATION TO PARENTS/GUARDIANS, SPONSORS AND RECRUITERS

To: Registrar, Tulane University
From:





Date of Birth




In accordance with the Family Education Rights and Privacy Act of 1974 (FERPA), also known as the Buckley Amendment, Tulane University does not disclose student records without prior consent of the student. 
My signature on this release form permits the University to discuss my records with your parents/guardians, your sponsor (if applicable), and your recruiter, as indicated with the person(s) named below. The following records may be released (select one):
If you selected 'Other' above, please specify here

*This release does not apply to Campus Health records. Release of medical records occurs after treatment is provided and requires execution of the Authorization for the Release of Confidential Health Information. To learn more about privacy and confidentiality visit https://campushealth.tulane.edu/policies/confidentiality.

This Authorization remains in effect until revoked by me in writing.




I consent to the disclosure of any personally identifiable information from my education records to the individual(s)/organizations(s) named below, for reasons determined by the Tulane University.  I understand that the purpose of the disclosure is to inform the parties listed below of my progress and status at Tulane University, as well as any circumstances affecting my attendance at Tulane University.  I understand that my education records may be disclosed to my parents/guardians identified below through a recruiter identified below and that the recruiter may only re-disclose education records to my parents/guardians if identified below.  This authorization will remain in effect for the duration of my tenure at Tulane University, but I may revoke the consent by providing written notice at anytime.*
Please type your full name
Parents/Guardians:
1.



2.



Sponsor (if applicable):




Recruiter:




Submit
To complete the FERPA submission process, follow these steps:
  1. Click the "Submit" button below. 
  2. Review your information on the form that opens.
  3. Add your e-signature and click the "Submit Signed Response" button. 
  4. Once you have submitted your e-signature, a verification email will be sent to you. Click the link in the email you receive to complete the submission process.

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