WP E-Signature by Approve Me - Sign Documents Using WordPress -

FERPA

INSTITUTION INFORMATION:

Woodmont College
16375 NE 18th Ave. Suite 304
North Miami Beach, FL 33162
Tel: (305)944-0035
Licensed by CIE of the Florida Dept of Education | NECHE Accredited

Family Education Rights and Privacy Act (FERPA) Information Disclosure Release Form

FERPA, the Family Education Rights and Privacy Act, is a Federal Law protecting the privacy of student educational records. Schools must have written permission from a student before releasing non-directory information such as academic or financial records to other parties.

By signing this document, I am giving or revoking my consent for Woodmont College officials to discuss the contents of my academic record, including coursework and grades, and/or financial record, with the following parties. I understand I may revoke consent at any time by submitting this form.

Student Name:

I am access to my records to:

Academic Records:

Grant Consent

Revoke Consent

Financial Records:

Grant Consent

Revoke Consent

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

March 10, 2025 6:43 am EST

FERPA Uploaded by Rivka Levine - tech.support@woodmontcollege.edu IP 147.235.200.219

March 10, 2025 6:45 am EST

Bluma Kaye - admissions@woodmontcollege.edu added by Rivka Levine - tech.support@woodmontcollege.edu as a CC'd Recipient Ip: 147.235.200.219