Bossier Parish Community College
6220 East Texas Street
Bossier City, LA 71111
Family Educational Rights and Privacy Act
The Family Educational Rights and Privacy Act (FERPA), otherwise known as the Buckley Amendment,
provides that there are certain rights of the student to have access to educational records. This form
addresses only the records maintained in the Admissions/Registrar’s Office, the Billing Office
and the Financial Aid Office at Bossier Parish Community College.
We have provided this form so that the STUDENT may authorize persons other than him/herself to
personally, telephonically, or electronically make inquiries about information maintained in the
Admissions/Registrar’s Office, the Billing Office and the Financial Aid Office pertaining to the student.
Additionally, the STUDENT must provide the information requested below if the student wishes to make
telephonic or electronic inquiries and receive individualized information from our office.
The information will be provided to anyone who can provide the access code and the STUDENT’S Social
Security Number or student ID number. This code is restricted to only persons who have a “need to
This code will be entered into the student records system and will be used to allow or restrict access until
the STUDENT either rescinds the authorization in writing to this office or provides a new access code
which will immediately replace the one in force. If we do not have one on file, we will not be able to
discuss admissions data with anyone unless the student is present and allows access.
The student must write any combination of five (5) numbers in the following blocks, sign and date this
form, and return it to the Admissions/Registrar’s Office. To increase security the number should not be
sequential (such as 12345) or repeating (such as 11111).
________________________ OR ______________________
Date of Birth
BPCC Student ID Number
Social Security Number
IF NOT DELIVERED IN PERSON,
A COPY OF A STATE OR FEDERAL ID MUST BE SUBMITTED WITH THIS FORM.