Consent To Release Applicant/ Student Information - Red River College Page 2

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Consent to Release Applicant/

Student Information

Freedom of Information and Protection of Privacy Act (FIPPA)

The same law that gives parents and students access to and control over a child’s educational records during elementary and high school transfers

ownership of the records to the student at the college level.

College students are considered responsible adults and are allowed to determine who will receive information about them and their studies. Under this law,

confidential student information cannot be provided to anyone other than the student unless the student has provided written consent to the College.

I ____________________________________________ , (student number) ___________________________ , hereby authorize and consent to the release of information

held by Red River College, specifically my demographic, application and registration, financial account (excluding Tuition and Education Credit

Certificates T2202A Tax Receipts), student account usernames and passwords (if available), and grades information contained in, or as a part of, my Red

River College education to the following person(s):

Name:

Relation/Organization:

Name:

Relation/Organization:

Name:

Relation/Organization:

Consent Expiration Date (dd/mm/yy): ________________________

If no date is indicated, consent will expire three years from the signature date below, or when Red River College is notified otherwise in writing.

Comments/Special instructions:

Signature

Date (dd/mm/yy)