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University of California, RiversideUCR



FERPA / Student Conduct Record Release    


FERPA 

Directions for Completing the FERPA/Student Conduct Record Release Form

 Print a FERPA/Student Conduct Record Release Form (PDF).


Use these directions to complete each section of the form successfully. 

Name

The top of the form should contain the identifying information of the person to whom the information is to be released. If you wish to have your own information released to yourself, put your own identifying information.

Purpose

Indicate your purpose for having the information released. This is helpful in guiding staff members when releasing information to third parties. For instance, if your intention in having information released to a counselor is to have the counselor better understand the behavioral history in order to identify a course of treatment for a student, this is important information for SCAIP staff to know when discussing the file with the counselor.

How You Want to Release Information

      • "Verbal communication" means that the information in the file may be discussed. This must be indicated if a student is going to have an advisor with them in a meeting, since information regarding the student's file will be released to a third party.
      • "Copies of documents only" is indicated when the student wishes to have copies of the documents in their file. Where appropriate, third party student information will be redacted. Copies of documents are not provided until payment is received by SCAIP. The cost of copying is provided on the second page of the form. There is an extra charge for mailing copies.

What Information to Release

      • If you have more than one incident, this section is what allows you to control whether the information released pertains to the current issue or the previous one(s).
      • Releasing all information is just that; all information in the file.
      • If you wish to indicate a particular issue, you must check off the second option and indicate the specific date of the issue you want released.
      • If you only want information regarding a specific document, for example a copy of the paper that has been referred, or a copy of the incident referral form that was submitted, you should indicate the last option in this section, as well as the specific document.

Date of Range for Release

This section allows you to specify how long you wish to have the information released. If you're completing the form for the intention of having an advisor present, we recommend indicating the last "one time release" option.

Hearing Tapes/Duplication

      • SCAIP only records committee reviews that go before the Student Conduct Committee and College Academic Integrity Committees. Therefore, this section only applies to students who wish to obtain tapes/CDs from theses types of hearings.
      • You must indicate whether the tape/CD will be picked up or mailed. There is a cost associated with duplication of tapes/CDs and an additional cost for shipping copies of tapes/CDs.

Submitting the Release of Information Form

    • Bring the completed form in person to Student Conduct & Academic Integrity Programs in 111 Costo Hall.
    • You will be asked to present identification and should be prepared to do so.
    • If there is duplication (photocopies or tape/CD duplication) required, your request will not be processed until payment is received. Therefore, it is recommended that you use the copy fee chart on page 2 of the form to estimate the costs, and come with a blank check in order to properly submit payment.


More Information

General Campus Information

University of California, Riverside
900 University Ave.
Riverside, CA92521
Tel: (951) 827-1012

Department Information

Student Conduct and Academic Integrity Programs
111 Costo Hall

Tel: (951) 827-4208
Fax: (951) 827-7849
E-mail: conduct@ucr.edu

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