Consent for Release of Education Records
Completion of this document authorizes the disclosure and use of education records as described below. Completion also authorizes you to discuss this information with representatives of the organization named below entitled to receive said information. If you have any questions regarding this form, please email the Director of Student Information Services, Ms. Khuloud Hajjiri Assaf at email@example.com.
Use and Disclosure Information
The education records described above shall be released to the following:
Authorization and Approval