-FOR CAMPUS USE ONLY –
DEPARTMENTAL FERPA RELEASE
CaliforniaPolytechnicStateUniversity
San Luis Obispo, CA93407
The Family Educational Rights and Privacy Act of 1974 (FERPA) as amended is a federal law which is designed to protect the privacy of andlimit access to the education records of students. This means that institutions generally may not provide such information to others unless the student gives permission, or if the information constitutes “directory information”[1] and the student has not placed a privacy restriction on disclosing this information.
FERPA specifies that a written consent must:
1)Specify the records that may be disclosed;
2)State the purpose of the disclosure; and
3)Identify the party or class of parties to whom the disclosure may be made.
FERPA further provides that upon request the student is entitled to a copy of the records disclosed.
The University understands that there are occasions when the student wishes to have information shared with others. To assist students, each Cal Poly department has theoption of allowing students to have FERPA information available in their department released to designated individuals. Some departments may not provide this service because of legal requirements (e.g., law enforcement or medical records) or department preference.
The FERPA Release template is located below. If a department wants to use the template, it must be modified, as noted prior to use. The form is to be provided by the campus department and completed and submitted by the student. Theseforms are to be retained in the requested office and must comply with the retention schedule of the related education record.
Note: This process does not preclude campus departments from providing student information to other campus departments provided the disclosure is for legitimate educational needs.
DEPARTMENTAL FERPA RELEASE
CaliforniaPolytechnicStateUniversity
San Luis Obispo, CA93407
[Name of Cal PolyDepartment – to be printed on document]
The purpose of the Family Educational Rights and Privacy Act (FERPA) is to protect the privacy of information concerning individual students by placing certain restrictions on the disclosure of “non-directory information”[2]contained in a student’s university records. I understand that I have the right not to consent to the release of my education records and I have the right to receive a copy of such records upon request.
Name of Student: ______EmplID/SSN: ______
(Please Print)
I, the undersigned, hereby authorize California Polytechnic State University (Cal Poly) to release the following education records and information (The campus department may wish to specify the records or types of records available from their department instead of having the student fill out this information. For example: Advising – Graduation Requirements.):
- ______
2. ______
3. ______
To the following Person/Agency:
Name: ______
Address:______
______
Telephone:______
For the purpose of(e.g., providing a recommendation, providing information about, etc.):
______
______
I understand that this authorization remains in effect from today through ______(Month/Year).
I also understand that it will be necessary to send a written request to revoke this authorization prior to the date indicated.
______
Student’s SignatureDate
Questions and Answers
Q: What is FERPA
A: FERPA is the Family Educational Rights and Privacy Act of 1974, as amended. It is a federal law regarding the privacy of student records and the obligations of the institution, primarily in the areas of release of the records and the access provided to these records. Cal Poly is bound by FERPA requirements since we receive funds from programs administered by the U.S. Secretary of Education. If the campus fails to comply with FERPA funds administered by the Secretary of Education may be withheld.
Q: What are education records?
A: Under FERPA, education records are defined as records that are directly related to a student and are maintained by an education agency or institution or by a party acting for the agency or institution. Education records can exist in any medium, including: typed, computer generated, videotape, audiotape, film, microfilm, microfiche and email, among others.
Education records do not include such things as:
- “Directory information”[3] unless the student has placed a privacy restriction on disclosing such information.
- Sole possession records, i.e., records/notes in sole possession of the maker, used only as a personal memory aid and not revealed or accessible to any other person except a temporary substitute for the maker of the record (this might include notes an instructor makes while providing career/professional guidance to a student);
- Medical treatment records that include but are not limited to records maintained by physicians, psychiatrists, and psychologist in their professional capacity, and which are used for the treatment of the student;
- Employment records when employment is not contingent on being a student, provided the record is used only in relation to the individual's employment;
- Records created and maintained by a law enforcement unit used only for that purpose and are revealed only to law enforcement agencies of the same jurisdiction;
- Post-attendance records, i.e., information about a person that was obtained when the person was no longer a student (alumni records) and does not relate to the person as a student.
Q: Do my parents have access to my education records?
A: No. Even parents are not permitted access to their son or daughter’s education records, including minors enrolled at Cal Poly, unless the student has provided written authorization permitting the parents’ access.
Q: Do I need a FERPA Release form for written or verbal requests for recommendations (e.g., graduate programs, jobs, research opportunities, etc.) for students?
A: Statements made by a person making a recommendation that are made from that person’s personal observation or knowledge do not require a written release from the student who is the subject of the recommendation. However, if personally identifiable information obtained from a student’s education record is included (GPA, grades, etc.), the writer is required to obtain a signed release from the student. This letter would become a part of the student’s education record and the student has the right to read it unless he/she has waived that right.
Q: Why isn’t there a general FERPA Release form instead of one for each department?
A: There are specific requirements as to what must be included in the written consent. FERPA 99.30(b) states: The written consent must: 1) specify the records that may be disclosed; 2) State the purpose of the disclosure; and 3) Identify the party or class of parties to whom the disclosure may be made. This release form allows for the identification of the specific information to be released. In addition, some departments may not provide student information due to legal requirements or departmental preference.
Q: Can I use student data to populate a classroom exercise?
A: No. The use of student data may violate FERPA and therefore should not be used. In addition, there are state and federal privacy laws that may be violated depending on the data elements used. Lastly, it is also not appropriate to use student data for other than its intended purpose.
Q: Where can I go for more information?
A: For more information visit the Office of Academic Records FERPA website at or contact the Office of Academic Records at 756-2531. The Office of Academic Records is located in AdministrationBuilding, Room 222.
[1] Directory Information consists of the following: name, local address, local telephone listing, email address, place of birth, major, dates of attendance, degrees and awards received, photograph, weight and height of athletic team members, most recent previous educational institution attended, participation in officially recognized activities and sports.
[2] Directory Information consists of the following: name, local address, local telephone listing, email address, place of birth, major, dates of attendance, degrees and awards received, photograph, weight and height of athletic team members, most recent previous educational institution attended, participation in officially recognized activities and sports.
[3] Directory Information consists of the following: name, local address, local telephone listing, email address, place of birth, major, dates of attendance, degrees and awards received, photograph, weight and height of athletic team members, most recent previous educational institution attended, participation in officially recognized activities and sports.