Form -- Student's Permission for the ISS Staff to Speak with Parents
International Students and Scholars (ISS) is limited in the amount of information we can share with parents. The 1974 Family Educational Rights Act, commonly known as FERPA, and College policies do not permit ISS staff members to share information about a student's educational record--even with parents--unless the student gives us written permission to do so. Some parents are uncomfortable with this law and school policy. If you and your son or daughter feel there is a need for ISS staff to share information with you or someone else, please have your son or daughter complete and sign the form below. TO WHOM IT MAY CONCERN:
I, ____________________________________________, give the staff of International Students and Scholars (ISS) at Lewis & Clark College permission to contact my parents, guardians or other selected individuals about any issues regarding my academic records, financial responsibilities, academic performance and life at Lewis & Clark College. I understand that I have a right to withhold any information regarding my academic records, financial responsibilities, academic performance and life at Lewis & Clark College, but I waive that right by signing this document.
I understand that I can cancel this waiver at any time by submitting a statement in writing to ISS. I agree that once I decide to cancel this waiver, ISS staff may inform my parents, guardians or other individuals named on this waiver of my decision.
Individuals to whom information can be released:
1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
4. _________________________________________________
5. _________________________________________________
___________________________________________________
Student's Name (Print clearly)
___________________________________________________
Student's Signature
___________________________________________________
Date
You may mail, fax or scan/email this form to:
International Students and Scholars
Lewis & Clark College - MSC 192
0615 SW Palatine Hill Road
Portland, OR 97219-7899
USA
FAX: 503-768-7301
Email: iso@lclark.edu
| 
