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Consent to Disclose Information

Consent to Disclose Information 

Students are required to complete a Student Consent to Discloser form directing Carson-Newman University to disclose otherwise confidential information to certain individuals, such as parents. No information can be released from any college office prior to completion of the consent form.  The consent shall remain in effect unless revoked by signature and provided hereafter.The student may revoke his/her consent at any time in writing in the Office of the Registrar.

The following information is provided on the consent form.

Person(s) to whom disclosure may be made

Name

Telephone number

Address, City, State, Zip

If mailing address or telephone number of the person changes, it is the student’s responsibility to advise the college in writing by completion of a new Consent to Disclosure form  in the Office of the Registrar.

The following categories are available for disclosure according to student’s signed consent

Grades  

Academic progress, and course and degree requirements

Class attendance and completion of assignments

Disciplinary charges and actions

Physical, mental health and safety concerns

Financial Assistance and financial awards, including institutional, federal and state aid

Billing and Account information

Other, specified   

A password must be provided by the student on the form so that approved persons can be verified in telephone conversations with University officials. 

SIGNATURE MUST BE WITNESSED AND VERIFIED BY CARSON-NEWMAN STAFF

FAXED OR MAILED FORMS ARE NOT ACCEPTED 

*Disclosure forms are located in the Registrar’s Office /Fite Administration Building