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Consent to Release of Information

Counseling Department

Family Education Rights and Privacy Act (FERPA)


The FERPA is a federal law that protects the privacy of a student's educational records. FERPA applies to all educational institutions receiving funds from the US Department of Education. Western Texas College cannot, except in certain limited situations, release grades or other personally identifiable information to any person other than the student without a written release from the student.
* Indicates required information, incomplete forms cannot be processed.

I understand by signing this authorization, I am voluntarily waiving my rights of non-disclosure of my educational records listed above under the federal law only as to the person(s) or organization specifically listed. This release does not permit the disclosure of these records to any other person(s) or entities without my written consent. I understand that I am not required to release my education records to anyone and that this release remains in effect until I request in writing the revocation of this consent. I also acknowledge that I have received information regarding FERPA and I understand the information presented. If I have further questions, I will contact the counseling department for assistance.

By clicking "Yes", I electronically sign this application and agree that this information is complete and correct, and I understand that the submission of false information is grounds for appropriate disciplinary action.