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1. Student Information: Full legal name, student ID number, date of birth, and current contact information of the student whose records are to be released
2. Educational Institution Details: Name and address of the institution currently holding the educational records
3. Recipient Information: Name, title, and complete contact information of the person or organization authorized to receive the records
4. Records Specification: Detailed description of which specific records or information are authorized for release (e.g., academic transcripts, attendance records, behavioral records, etc.)
5. Purpose of Release: Clear statement of the reason for releasing the records and how they will be used
6. Duration of Authorization: Specific time period for which this authorization is valid
7. Authorization Statement: Formal statement of authorization, including reference to relevant privacy laws and acknowledgment of rights
8. Signature Block: Space for student's signature (or parent/guardian if applicable), date, and witness signature if required
1. Parent/Guardian Information: Required only if the student is a minor or if parent/guardian authorization is legally required
2. Previous Names: Include if the student has had any name changes during their academic history
3. Special Instructions: Any specific handling instructions or restrictions on how the information should be transmitted or used
4. Revocation Statement: Information about how and when the authorization can be revoked
5. Multiple Institution Authorization: Include if records are to be released from multiple educational institutions
1. Schedule A - Detailed Record List: Comprehensive list of specific records to be released, if too detailed to include in main document
2. Schedule B - Identity Verification Documents: Copies of required identification documents to verify student identity
3. Schedule C - Institutional Forms: Any specific forms required by the educational institution for record release
Authorization Period
Authorized Recipient
Confidential Information
Educational Institution
Educational Records
Financial Records
Legal Guardian
Official Transcript
Parent
Personal Information
Privacy Laws
Records
Registrar
Releasing Institution
Student
Student Information
Third Party
Transfer of Records
Unofficial Transcript
Education
Human Resources
Healthcare
Legal Services
Government Services
Professional Licensing
Immigration Services
Employment Services
Financial Services
Insurance
Academic Affairs
Student Services
Registrar's Office
Compliance
Legal
Human Resources
Admissions
International Education
Privacy and Information Management
Administrative Services
Registrar
Privacy Officer
Academic Advisor
Human Resources Manager
Admissions Officer
Immigration Consultant
Educational Administrator
Compliance Officer
Student Services Coordinator
Records Manager
Legal Counsel
Enrollment Manager
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Genie’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; Genie’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it


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