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Freshman Admissions

Release Of Personally Identifiable Student Information

Student consent is required for the release of
personally identifiable information
such as semester grades, academic record,
class schedule, current academic standing, student ID and/or Social Security number.
Students may consent to the release of
personally identifiable information
to others by completing this form. The Family
Educational Rights and Privacy Act of 1974 (FERPA) allows disclosure of personally identifiable information without student
consent to:
Florida Institute of Technology
n
Office of the Registrar
150 West University Boulevard, Melbourne, FL 32901-6975
n
(321) 674 +ext.
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Fax (321) 674-7827
General Information – ext. 8115, Graduation – ext. 8116, Records and Transcripts – ext. 8117, Registration – ext. 8118
Office of the Registrar Use Only
Operator Initials
___________________________
Date Processed
____________________________
RGR-103-511
certain government agencies/officials,
ƒ
sponsoring agencies,
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outside contractors performing a service for the institution that the institution would otherwise perform
ƒ
for itself,
National Science Foundation surveys as authorized by Congress,
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subpoenas/court orders, select law enforcement agencies, and
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selected school officials on a need to know basis who have defined legitimate educational interest in
ƒ
such records.
This request will remain in effect indefinitely, until the student named below notifies the Office of the Registrar otherwise
in writing.
I give permission for the individual(s) named below to request in writing copies of my academic grades and transcript
(fee required for official transcript), financial status, payment information and other personally identifiable information
contained in my university records. University policy requires a written request to obtain these documents.