FERPA Waiver

You can complete this online form to grant a faculty member permission to use your work for teaching or research purposes. You waive your right to privacy under the Family Educational Rights and Privacy Act of 1974 (FERPA) under the conditions that you specify.

Name(Required)

First Last

Name of Faculty Member Permitted to Use Your Work(Required)

Faculty Member’s Email(Required)

Please ensure that you enter the correct email address. Otherwise, the faculty member will not be notified that you have completed this form.

Course and Section(Required)

Example: ENGL 102-4T1

What work can the faculty member use?(Required)

Any of my work from this course

A specific work

Title or Description of the Work(Required)

I grant permission for my work to be used in the following ways:(Required)

Check all that apply.

For educational purposes (for instance, as a sample to share with future students)

For research purposes (such as for use in a presentation or published article)

I grant permission for my work to be shared:(Required)

Select all that apply.

Anonymously, without my name

With my name

For this time period:(Required)

Indefinitely

Until a certain date

Date(Required)

Signature(Required)

Name

This field is for validation purposes and should be left unchanged.

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