The University of Central Oklahoma

Personal Record Access Form

 

In accordance with the Family Educational Rights and Privacy Act of 1974, as amended, “eligible students” are entitled to access official educational records directly related to the student, including the right of inspection and review.  “Eligible students” are those students who have reached the age of 18 and/or attends a school beyond the high school/secondary level.  Requests for records kept in Enrollment Services should be directed to Enrollment Services in accordance with University regulations.  Student Conduct records may be requested by contacting the Office of the Vice President for Student Affairs at (405) 974-2361.  (Parents of a dependent student as defined in Section 152 of the Internal Revenue Code of 1954 are entitled to access to official educational records of that student.)

 

Access Rights

The right of access includes:

1.  The right to a list of the types of educational records maintained by the institution and directly related to students;

2.  The right to inspect and review the content of those records;

3.  The right to obtain copies of those records, which may be at the expense of the eligible student or parent.  Parents of a   dependent student as defined in Section 152 of the Internal Revenue Code of 1954 are entitled to access to official educational records of that student;

4.  The right to a response from the institution to reasonable requests for explanations and interpretations of those records;

5.  The right to inspect and review or to be informed of specific information about themselves which is contained in any material or document on more than one (1) student.

6.  The right to an opportunity for a hearing to challenge the content of those records.

 

If a student wishes to review, access, and/or make a copy of a record in their file, then the student must complete this form.

 

ACCESS PROTOCOL

 

Please state requested information to be accessed.

____________________________________________________________________________________________

 

____________________________________________________________________________________________

 

Please state the reason for the release of such information.

 

____________________________________________________________________________________________

 

Please circle the medium in which the information will be accessed:                          Visual                     or                   Copy

 

Copies—$0.10 per page

 

Student Name (PRINT):___________________________________________

 

Student Signature:________________________________________________                             Date:________________

 

______________________                             ____________________                                 _________________________

Student Banner ID#                                            Date of Birth                                                        Social Security Number

 

Parent/Guardian Name (PRINT):___________________________________

 

Parent Signature:________________________________________________                               Date:________________

 

“FOR UNIVERSITY DEPARTMENTAL USE ONLY”

 

Authorized by (PRINT):_____________________________________               Department:__________________________

 

Signature:_________________________________________________          Date:________________________________