Confidentiality Forms | Penn State Office of the University Registrar

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header"><a class="nav-link" href="/confidentiality/">Confidentiality</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/confidentiality-student-records.cfm">Confidentiality of Student Records</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/student-rights.cfm">Student Rights Under FERPA</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/parent-rights.cfm">Parent Rights Relating to Educational Records</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/directory-information.cfm">Directory Information</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/other-exceptions-prior-written-consent.cfm">Other Exceptions to Prior Written Consent</a></li> <li class="nav-item active"><a class="nav-link" href="/confidentiality/forms/index.cfm">Confidentiality Forms</a></li> <li class="nav-item"><a class="nav-link" href="../faculty-staff/service-center/ferpa-incident-reporting/index.cfm" target="_blank">FERPA Incident Reporting Form</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/guidelines-faculty-staff/index.cfm">FERPA Guidelines for Faculty and Staff</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/guidelines-researchers.cfm">FERPA Guidelines for Researchers</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/ferpa-frequently-asked-questions.cfm">FERPA Frequently Asked Questions</a></li> <li class="nav-item"><a class="nav-link" href="/confidentiality/solomon-amendment/index.cfm">Solomon Amendment</a></li> </ul> </div> </div> <div class="col-lg-9"> <h1>Confidentiality Forms</h1> <h2>Agreement with External Research Organization</h2> <p>FERPA authorizes the disclosure of student education records without prior written consent to organizations conducting research studies on behalf of the University, provided there is a written agreement between the University and the research organization. This form serves as a template written agreement for use with external research organizations.</p> <a class="btn link-page-btn" href="https://policy.psu.edu/sites/default/files/WrittenAgreementExternalResearchOrganizations.doc">Download Agreement with External Research Organization Template</a> <h2>Student Consent for Release of Information to Third Parties</h2> <p>Students may choose to allow the release of their education records to specified third parties by completing this form. This Consent for Release of Information is a one-time authorization specific to the details of this request only. It is not intended to provide open-ended, delegated access to a student's record for an extended time period, such as an entire term.</p> <p>Students may grant access through the Delegated Access function within LionPATH to information such as grades, class schedule, financial aid, holds, etc.</p> <p>Students may grant access to Authorized Payers (Parents/third parties) in LionPATH to enable them to view and pay the Student Account Statement, enroll in the Installment Payment Plan and access IRS Form 1098-T.</p> <p>The following link will provide information needed to establish the Delegated and/or Authorized Payor Access: <a href="https://lionpathsupport.psu.edu/faqs/student-faqs/access/" target="_blank">https://lionpathsupport.psu.edu/faqs/student-faqs/access/</a>.</p> <p>The University reserves the right to review and respond to requests for release of education records on a case-by-case basis.</p> <a class="btn link-page-btn" href="student-consent-release-information-third-parties-form.pdf" target="_blank">Download Student Consent for Release of Information to Third Parties</a> <h2>Letter of Recommendation Request</h2> <p>Students requesting references for employment or other purposes from faculty and/or staff must make this request in writing so that proper consent can be collected. If written consent is not received, faculty and staff are limited to providing only <a href="../directory-information.cfm">directory information</a> and personal observances of the student.</p> <p>Students may also waive their right to review the letter of recommendation. The waiver is permanent and may not be withdrawn.</p> <p>The Request for Letter of Recommendation form should be completed and delivered in person, faxed, mailed or emailed as an attachment from the student's psu.edu email address to the faculty or staff member providing the recommendation. A separate form should be completed for each request.</p> <a class="btn link-page-btn" href="../../student-forms/request-letter-recommendation.cfm">Download Request for Letter of Recommendation Form</a> <h2>Request to Remove the Action of Withholding Directory Information</h2> <p>Students may reverse a request to withhold directory information by submitting a request to remove the action of withholding directory information form.</p> <a class="btn link-page-btn" href="../directory-information.cfm">Learn More about how to Request to Remove the Action of Withholding Directory Information</a> <h2>Request to Withhold Directory Information</h2> <p>All students may request that directory information not be released publicly by completing a request to withhold directory information form. Before submitting a request to withhold directory information, students should review what services and processes will be impacted. Requests to withhold directory information are in effect until removed, in writing, by the student.</p> <a class="btn link-page-btn" href="../directory-information.cfm">Learn More about How to Request to Withhold Directory Information</a> <h2>Statement of Understanding of University Policies for Student Employees</h2> <p>Students who are employed at Penn State may have access to student education records of other students at the University. Like all University faculty and staff, student employees are required to maintain the confidentiality and privacy of all such records during and after their employment. This form must be completed and signed by all student employees to confirm an understanding of FERPA requirements and other related policies.</p> <a class="btn link-page-btn" href="statement-understanding-university-policies-student-employees-form.pdf" target="_blank">Download Statement of Understanding of University Policies for Student Employees Form</a> </div> </div> </div> <div style="display:none"> <form name="registrargoogle" method="get" action="https://www.google.com/cse" id="cse-search-box"> <div> <input type="hidden" name="cx" value="004957947254114497749:scsrpi9e60e" /> <input type="hidden" name="ie" value="UTF-8" /> <input type="hidden" name="q" value="" /> </div> </form> <form name="psugoogle" method="get" action="https://www.psu.edu/search"> <input type="hidden" name="query" value="" /> <input type="hidden" name="client" value="PennState" /> <input type="hidden" name="proxystylesheet" value="PennState" /> <input type="hidden" name="output" value="xml_no_dtd" /> <input 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