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The Office of Student SuccessEganHall,Room105 Phone:740p 284p 5358/Fax:740p 284p 7095 ***CONFIDENTIAL*** CONSENTANDAUTHORIZATIONTORELEASEINFORMATIONTOSASS PursuanttoFederalandStateGuidelinesconcerningmyrighttoconfidentialityandprivileged
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How to fill out student authorization statement

01
Obtain a student authorization statement form from the relevant department or office.
02
Fill out your personal information including full name, student ID number, and contact information.
03
Provide details about the purpose of the authorization statement.
04
Sign and date the form to certify that the information provided is accurate.
05
Submit the completed form to the appropriate recipient for processing.

Who needs student authorization statement?

01
Students who need to authorize someone else to act on their behalf for specific matters such as picking up documents, accessing records, or making decisions related to academics or finances.
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Student authorization statement is a document where a student gives permission for a designated individual to access their educational records or make decisions on their behalf.
Any student who wishes to grant access to their educational records to another individual is required to file a student authorization statement.
Student authorization statements can typically be filled out online through the student portal of the educational institution. The student will need to provide their personal information, the name of the individual they are authorizing, and specify the level of access being granted.
The purpose of student authorization statement is to protect the privacy of students' educational records while allowing designated individuals access for legitimate reasons such as academic counseling or financial aid assistance.
Student authorization statement typically includes the student's name, student ID number, the name of the authorized individual, and the level of access being granted.
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