TWU Concurrent Admission - Student Consent to Release Records Form

The Family Education Rights and Privacy Act of 1974 (FERPA), provides for the confidentiality of student education records. An educational institution may not disclose information about a student nor permit inspection of a student's records without the student's permission unless such action is covered by certain exceptions under FERPA. THIS AUTHORIZATION MAY BE REVOKED AT ANY TIME.

Student Consent to Release Education Records Form

* required fields

First Name

Middle Name

Last Name

Date of Birth

Phone

By clicking the Authorization checkbox below I hereby give my consent and grant authorization to Texas Woman’s University College of Nursing, including but not limited to Administrators, Faculty and Staff thereof, to release or disclose the educational records to the party or parties named below. I further authorize that TWU College of Nursing may discuss the information contained in the specified records with the authorized recipient(s). I hereby waive all provisions of the law and privileges related to the records described in this disclosure.
I understand that I have the right not to consent to the release of my education records; I have the right to receive a copy of such records upon request; and that this consent shall remain in effect until revoked by me, in writing and delivered to the TWU College of Nursing 304 Administration Drive, Arts and Science Building, Room 216, Denton, Texas 76201 prior to receipt of any such written revocation.
I certify that I am over 18 years of age and have given my consent freely and voluntarily.
A signed copy of this Authorization may be used to the same extent as an original.

Authorization:

Agree

Page last updated 10:22 AM, November 30, 2021