FERPA Update Form

Personal Information

First Name

Last Name

OCU Email:

Birthdate:

Instructions

Below you have the option to identify up to two (2) individuals that will be able to access your personal information at Oakland City University. This will include information pertaining to, but not limited to: billing/payments, financial aid, grades, housing, etc. You are not required to release this information to anyone, BUT if you choose not to add any individuals to this form your parent(s)/guardian(s), i.e., will not be able to pay your bill or speak to financial aid on your behalf. Please complete all sections of this form, including initialing and signing when prompted.

Directory information, which is information that s generally not considered harmful or an invasion of privacy if released, can be disclosed to outside organizations without prior written consent. If you do not wish Oakland City University to disclose directory information without your consent, you must notify the Oakland City University Registrar in writing. Directory information is defined in the student handbook.

Consent/Decline

I wish to release my personal information

I DO NOT wish to release my personal information

Consent

I consent to the disclosure of any personally identifiable information from my education records, including my academic file, student account, financial aid received/pending, or loans that have been/will be disbursed to me, to the individual's identified below. I understand this authorization will remain in effect until a written or online request for a change has been provided.

I release my information to the following individuals:
(Please list anyone that you would like to be able to contact the university about any of your above accounts.)

Name of Individual #1:

Individual #1's Mailing Address

Country

Street

City

Region

Postal Code

Name of Individual #2:

Individual #2's Mailing Address

Country

Street

City

Region

Postal Code

In place of your signature, please type your full legal name.

Date:

Decline

*Students cannot be denied any educational services from Oakland City University if they refuse to provide consent.

I do not wish to disclose any personally identifiable information from my education records, including my academic file, student account, financial aid received/pending, or loans that have bee/will be disbursed to me.

I do not wish to disclose

In place of your signature, please type your full legal name.

Date:

Undergraduate students under 26 years of age:
Under the Family Educational Rights and Privacy Act (FERPA), Oakland City University is permitted to disclose information from your education records to your parents if your parents (or one of your parents) claim you as a dependent for federal tax purposes. Please indicate whether your parents claim you as a tax dependent.

Please check the appropriate box:

Yes, I certify my parents claim me as a dependent for federal income tax purposes. (Please provide name and contact information in the consent section.)

No, I certify that my parents do not claim me as a dependent for federal income tax purposes.

In place of your signature, please type your full legal name.

Date:

If you are not claimed as a dependent or do not know whether you are claimed as a dependent for federal income tax purposes, but you agree that Oakland City University may disclose your information from your education records to your parents, please list your parents in the consent section.