Section Identifier



"*" indicates required fields

The Federal Family Education Rights and privacy Act of 1974 (FERPA) is a federal law that gives students various rights with respect to their educational records. For the student’s protection, FERPA limits release of student record information without the student’s explicit written consent. You may, at your discretion, grant Bethany College permission to release information about your student records to a third party by submitting a completed FERPA Release Form. The College does not automatically send information to a third party. The specified information will be made available only if requested by the authorized third party.


Student Name*

, herby authorize Bethany College to disclose the following records upon request to the individual named below (Additional individuals must be added on additional forms).

Your Name*
Check each or all boxes you wish to grant access to the person named above.

By signing this release, I authorize Bethany College to release any student education records to the person listed above. Access granted to student education records via this form remains in effect until officially revoked by the student. I understand that I can revoke this access at any time in person at the Office of the Registrar by signing the revocation clause.

Student Name (acts as signature)*
This field is for validation purposes and should be left unchanged.