Family Education Rights & Privacy Act

Student Information

First Name*

Middle Initial*

Last Name*

Student ID #*

Birthdate*

Email*

Permanent Address*

Country

Street

City

Region

Postal Code

Student's Dependency Status

You have the right to consent to whom your education record is released. Grace College and Seminary does not assume the dependency status of our students and thus requires the written consent of the student to release financial and academic information to a student’s parents. Under the Family Educational Rights and Privacy Act (FERPA), Grace College and Seminary is permitted to disclose information from your education records to your parents if one or both of your parents claim you as a dependent for federal tax purposes. Please indicate whether your parent(s) claim you as a tax dependent.

Yes, I certify that my parent(s) claim me as a dependent for federal income tax purposes.

No, I certify that my parent(s) do not claim me as a dependent for federal income tax purposes.

I do not know if my parent(s) claim me as a dependent for federal income tax purposes.

In place of a manual signature, please type your full name as your electronic signature:*

Student's Consent

If you are not claimed as a dependent or you do not know whether you are claimed as a dependent for federal income tax purposes, but you agree that Grace College and Seminary may disclose information from your education records to your parent(s) or others, please sign the following consent. You will not be denied educational services from Grace if you decline to provide consent.

I would not like my Student Account, Financial Aid, Academic, or Student Affairs/Conduct information to be shared with anyone.

I would like my Student Account, Financial Aid, Academic, and/or Student Affairs/Conduct Information to be shared with one or more people. I have listed their names and contact information below.

For the complete FERPA policy, see the Student Right to Know page of the Grace College website.

This completed form is submitted to the Grace College Student Services Hub.

Family Education Rights & Privacy Act - FERPA Consent Form

Authorized Individuals:

Academics

Campus

Admissions