FERPA Release Form

FERPA Release Form for Student Papers Mt. Hood Community College Course: _____________________ Term: _____________________ Instructor: _____________________ One copy of each student's work (as specified in the course syllabus) will be filed in the MHCC Library for review by fellow students and faculty who might be able to use this information. The purpose of this form is to give the college permission to include your work in this collection. Your signature below will indicate your permission to use your report in this way, clearing MHCC of any copyright or FERPA (Family Educational Rights and Privacy Act) infringements. Your grade will not be affected by your agreement or lack of agreement to this use. You will retain the right to remove your paper from reserve at any time for any reason. I agree to have a copy of my report on file in the MHCC Library: Yes ______________ No ______________ My materials may be used until __________________. (month/date/year)

Signature ____________________________________ Date _________________________

Please print your name here:

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