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Student Consent to Release Information

This release pertains to Beal University: Bangor, Maine Campus and Wilton, Maine Campus.

In compliance with the Family Educational Rights and Privacy Act (FERPA) of 1974 as amended, Beal University will not release student grades, schedules, or financial aid information to parents, spouses, or others, unless written permission is given by the student.

Student name:

Last Four of SSN:

Date of Birth:

By signing below, I authorize the appropriate offices or personnel at Beal University, for
the purpose of monitoring my education, to release information regarding my Educational
Records which include:
Academic
Attendance Records
Financial Records
Other

We will not release copies of the student’s record to anyone without a signed Transcript Request Form from the student. We will not change a student’s information (address, phone, etc.) for anyone other than the student.

Name of parent(s), guardian, spouse or others that you wish to grant permission to: (Please put N/A if you are not giving permission to anybody)
Name: Last Four of SSN:
Name: Last Four of SSN:

*This information will only be used for identification purposes

This authorization will remain in effect until it is revoked in writing.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

March 26, 2021 2:46 pm EDT

Student Consent to Release Information Uploaded by Financial Aid - fa@beal.edu IP 71.255.159.238

March 29, 2021 8:51 am EDT

Document owner administrator@beal.edu has handed over this document to fa@beal.edu 2021-03-29 08:51:21 - 71.255.159.238

April 1, 2021 9:54 am EDT

Document owner fa@beal.edu has handed over this document to aloredo@beal.edu 2021-04-01 09:54:52 - 71.255.159.238

September 14, 2021 10:20 am EDT

Document owner aloredo@beal.edu has handed over this document to fa@beal.edu 2021-09-14 10:20:11 - 71.255.159.238