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I.T Consent to Release Form
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EOU Information Technology Consent to Release Information Form
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The Family Educational Rights & Privacy Act (FERPA) can be defined as: "A federal law designed to protect the privacy of educational record, to establish the right of students to inspect and review their educational records, and to provide guidelines for the correction of inaccurate and misleading data through informal and formal hearings."

Oregon law prohibits EOU from giving parents, spouses and/or other family members access to student information except with the student's voluntary written consent. EOU may release student information to parents, spouses and/or other family members only with the written consent of the student, regardless of the student's age, whether the student is a legal dependent of the parent, or who pays the student's tuition and school expenses.
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Student Name (please print):___________________________ Student ID#: __________________

Recipient(s) Information: ______________________________________________________________________
(Full name and relationship)
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By initialing below, I give my written consent for Eastern Oregon University's I.T office to disclose the following:




____ Eastern Oregon University E-mail Password

____ Eastern Oregon University E-mail Address/Username

____ Eastern Oregon University Student I.D Number
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Student Signature: _______________________________________ Date: ____________________

This release will remain in effect until you graduate, fall out of continual enrollment, or revoke it in writing. The above information will not be automatically released; the authorized party must initiate a request. EOU is required to keep original signed consent forms. We suggest that students keep a copy of this form for their records. Please drop this form off to EOU IT in Ackerman 209, or fax it to 541-962-3712
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Reciept date: _____________ Staff Initials ______________
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