• Business Office Student Information Release Form

  • The Family Education Rights and Privacy Act (FERPA) is a Federal law that protects the privacy of student education records. Under FERPA, a school may not generally disclose personally identifiable information from an eligible student"s education records to a third party (including parents) unless the eligible student has provided written consent. All students must complete this form even if you do not want to provide consent. More information on FERPA can be found at http://www.ed.gov

  • STUDENT INFO

  • Date of Birth*
     - -
  •  
  • Do you wish to allow persons you specify access to your business office records?*
  • Would you like the Business Office to send a copy of your monthly statement of your student account to someone?*

  • I would like a copy of my monthly statements sent to the following email address. In submitting this form, I also understand that a copy will continue to be sent to this address the entire time I am a student at ABC until I notify the Business Office in writing to stop sending to this address.

  • Do you allow the Business Office to share only your account balance to any persons desiring to make a payment on your account?*

  • AUTHORIZATION OF DISCLOSURE

  • I understand that this agreement to disclose my business office records will be in effect from the date signed through my entire period of enrollment at Appalachian Bible College. I further understand that I must notify the Business Office, in writing, if I choose to modify or revoke this agreement.
  • Date*
     - -
  • Should be Empty: