STUDENT CONSENT TO RELEASE INFORMATION

This release pertains only to The University of Maine at Presque Isle

In compliance with the Family Educational Rights and Privacy Act (FERPA) of 1974 as Amended, The University of Maine at Presque Isle will not release student grades, schedules, or financial aid information to parents, spouses, or others, unless written permission is given by the student.

FERPA Release Form

Education records are kept by University offices to facilitate the educational development of students.  Faculty and staff members may also keep informal records relating to their functional responsibilities with individual students.

A federal law, the Family Educational Rights and Privacy Act of 1974, as amended (FERPA), also known as the Buckley Amendment, affords students certain rights concerning their education records.  Students have the right to have some control over the disclosure of information from their records.  Educational institutions have the responsibility to prevent improper disclosure of personally identifiable information from the records. 

Link:  Comprehensive FERPA Information at UMPI

Contact UMPI Office of Student Records: (voice) (207) 768-9540 (email) umpireg@maine.edu (fax) (207) 768-9458 

UMPI Student Consent to Release Information Form
Your Name: First, Middle, Last
Your Name: First, Middle, Last
First
Middle
Last

Name of parent(s), guardian, spouse, organization who you wish to grant permission to:

Click the Plus (+) icon to add additional courses
plus1 Add minus1 Remove

Acknowledgement

By signing below, I authorize the appropriate offices or personnel at The University of Maine at Presque Isle to release information regarding my Educational Records which include: Academic, Financial Aid, Billing, Student Employment and UMPI Student Code of Conduct information. Under no circumstances will The University release any medial information. The University may share Educational Records with those people who claimed you on last year’s income tax returns, regardless of permissions granted in this form.

We will not release copies of student’s record to anyone without a signed Transcript Request Form from the student. We will not change a student’s information (address, phone, etc.) or do pin resets for anyone other than the student.

By submitting this form you also acknowledge the following:

By entering my electronic signature below in this form, I hereby grant and authorize the University of Maine System, acting through the University of Maine at Presque Isle, (hereinafter UMPI) its employees and agents to make use of, or assign the use of my legal information for the purposes of my educational record(s). I agree to indemnify and hold UMPI, UMS, the University, its employees and agents, harmless from and against any and all claims, damages, lawsuits, judgments, and expenses, including reasonable attorneys’ fees, that UMS may become liable to pay or defend arising out of or caused by any matter or material furnished or spoken by me in connection with my request. I hereby release UMPI, UMS, its employees and agents from all expenses, claims and liabilities incurred by me arising out of or in connection with the use of the material, except to the extent that those expenses, claims or liabilities are the direct result of the negligent acts or omissions of  UMPI, the University of Maine system, its employees or agents. This agreement shall be governed and construed according to the laws of the State of Maine.

Please type your name (first, middle, last as a digital signature) and add the date 
Please type your name (first, middle, last as a digital signature) and add the date 
First, Middle, Last Name
Date

This information will only be used for identification purposes

This authorization will remain in effect until it is revoked in writing.