AVI American Vocational Institute

AVI Career Training FERPA Release Form

Student's Photo

Office of the Registrar

Student Authorization for Disclosure of Non-Directory Information

Student Name (Please Type your first, middle, last names Properly) ^*

Social: ^*

Date of birth: ^*

Expiration Date of Authorization: ( meaning you cannot release information after this date ) ^*

I hereby waive my rights under the Family Educational Rights and Privacy Act of 1974 (FERPA) and authorize the faculty and staff of AVI Career Training, to disclose my educational records to the following individual(s) or organizations indicated below.

Full Name (s):

Relationship to student

I understand that by signing this form I am giving consent to AVI Career Training to release my information to the non-institutional individuals or organizations listed above. Pertaining to my:

Financial Records

Academic Records

Social/Disciplinary Records

Other Records

Signature ^*

Date ^*