Consent to Release Student Information INTO George Mason University Fall 2015

What is FERPA? FERPA stands for Family Educational Rights and Privacy Act. Mason can’t share student information without your permission. This form allows us to share your information with the people listed in numbers 1-10. We only would need to do this to help you! This is a very basic description of what FERPA is. Make sure students understand that we will only release their information to help them, but we cannot do so without this form.

Filling out the form Start by filling in your name and G number. DJONES DJON DJONES G00000000 Your name should be the same as on your passport. They need to complete this entire box. The last animation on this slide is the G number.

Filling out the form Next, check all four boxes. They must check all four boxes. The last animation on this slide are the check marks.

Filling out the form Next, you may add other people to see your information. Third Parties Information May be Released to: 4. Educational Counselor/Agent Your agent helped you find INTO Mason 5. Sponsor/Scholarship Agency Your sponsor is who is paying for your classes 6. Embassy-Educational Advisor Your embassy is the official representative of your country The information will disappear shortly, but at the end, all of the descriptions will reappear. Remember, not all students will have an agent, sponsor, or embassy contact. If they do have one (or all) of these, they are not required to fill them out.

Filling out the form Next, you may add other people we can share important information with, if necessary. 7. Family Members or Other People Listed Below: Any other people you might want to share your information with. Parents, brother, sister, wife, husband, aunt uncle They are not required to fill this out, but may do so if they wish.

Filling out the form Djon Djon Djones On the back side, sign and date on the top Student Signature line. Djon Djon Djones 09/14/15 Students must sign and date the top line. The last animation on this page is the date.

Thank you for your help!