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FERPA Waiver Form Template

Create a Seamless FERPA Waiver Process for Your Institution

Handling student records without the necessary consent can be a challenging task. This FERPA Waiver Form Template is designed to help educational institutions streamline the process of receiving consent for the release of student records. With this customizable form, you can simplify record requests, ensure compliance with FERPA regulations, enhance data security for student information, and reduce administrative workload-all while maintaining a professional appearance. Try out the live template to see how easy it can be.

Use this Template (FREE) Live Preview
Student full name
Date of birth
Student ID number
Student email
Student phone
Institution name
Department or office handling this request
Recipient name or organization
Recipient email
Recipient phone
Recipient mailing address (if applicable)
If delivery method is Other, please specify
Verification PIN or passphrase for verbal release (optional)
Preferred delivery method
Email
Mail
In-person pickup
Secure portal
Fax
Verbal communication
Other (specify)
Records you authorize to be released
If records include Other, please specify
Scope of disclosure
Written records only
Verbal communications only
Both written and verbal
Type of information (directory vs. non-directory)
Directory information only
Non-directory academic records
Both directory and non-directory
Not sure
If purpose is Other, please specify
Purpose of disclosure
Effective date of this authorization
Duration of authorization
One-time release only
Until the expiration date specified below
Until revoked in writing
Until the end of the current academic year
Expiration date (if applicable)
I understand I may revoke this authorization in writing at any time, except to the extent action has already been taken based on it
Yes
No
I understand that records disclosed may be re-disclosed by the recipient and may no longer be protected by FERPA
Yes
No
I authorize the institution named above to disclose the records selected in this form to the recipient identified in this form
Yes
No
I understand this authorization is voluntary and not a condition of receiving educational services
Yes
No
I understand this authorization does not permit the recipient to make changes to my student record
Yes
No
Is the student under 18 years of age?
Yes
No
Parent/guardian full name
Relationship to student
Mother
Father
Legal guardian
Other (specify)
If relationship is Other, please specify
Parent/guardian email
Parent/guardian phone
I am the parent/guardian of the student named above and I consent to this authorization
Yes
No
Student signature
Date signed (student)
Parent/guardian signature (if applicable)
Date signed (parent/guardian)
Received by (office use)
Date received (office use)
{"name":"Student full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Student full name, Date of birth, Student ID number","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration depicting a FERPA waiver form for an article on FormCreatorAI.

When to use this form

Use this form when you, as the student, want to give written consent for your school to discuss or release your education records to specific people or organizations. It fits common cases like letting a parent view grades, allowing a scholarship program to verify enrollment, or authorizing an advisor to speak with a spouse. You choose which records, why, and how long access lasts. If your goal is to limit public directory details only, submit the Directory information opt out form instead. For official copies sent to another school or employer, use the Transcript request form. If a caregiver needs authority tied to custody, complete the Educational guardianship form. This keeps your privacy choices clear and your school in compliance.

Must Ask FERPA Waiver Questions

  1. Who is granting consent? (student full name, student ID, and contact email)

    These details verify identity and match the consent to the correct student record. Accurate contact info lets staff confirm requests and send updates if something is unclear.

  2. Which records may we disclose? (grades, enrollment, financial aid, billing, conduct, or all education records)

    Scoping the release prevents over-sharing and helps staff share only what is needed. If you also need a specific file sent, submit a Document request form for that item.

  3. Who can receive your information? (full names, relationship, organization, and contact details)

    Naming recipients with relationships ensures information goes only to authorized people. Contact details help staff verify identity before any disclosure.

  4. Why and how long is this consent valid? (purpose of disclosure and expiration date)

    Stating purpose shows a legitimate reason and guides staff on how to fulfill the request. An expiration date limits risk; you can submit a new form if you need more time.

  5. Do you acknowledge your rights, including the option to refuse or withdraw consent?

    This acknowledgment confirms informed consent and that you understand your privacy rights. It also explains how to withdraw or limit access so the school can stop sharing when you decide.

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