OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

FAMILY EDUCATION RIGHTS AND PRIVACY ACT FORM

Directions: Please print, complete and return to the Office of the Registrar.

The University of North Carolina at Pembroke is subject to and complies with The Family Educational Rights and Privacy Act. No one outside the institution shall have access to nor will the institution disclose any information from the student’s education records without the written consent of students. Officials of other institutions in which students seek to enroll, persons or organizations providing students financial aid, accrediting agencies carrying out their accreditation functions, person in compliance with a judicial order, and persons in an emergency in order to protect the health or safety of students are entitled to information from student educational records.

Within the University of North Carolina at Pembroke community, only those members, individually or collectively, acting in students’ educational interest is allowed access to student records.

All persons accessing student information are responsible for complying with the law. No parent, no spouse or provider is entitled to view the student’s records. Any exceptions to this will be handled through the Office of the Registrar. To ensure you are acting within the law, allow only the student to view information about him or herself. Be aware of those present in the room when accessing student data. Never give anyone your password and do not leave your terminal unattended while logged on.

The Family Educational Rights and Privacy Act and UNC-PEMBROKE policy provides sanctions for violation of the Act.

Your SIGNATURE below ensures compliance with this act and agreement to the rules governing Student Educational Rights and Privacy Act.

Faculty/Staff printed name: _____________________________________ Dept ______

Faculty/Staff signature: ________________________________________ Date ______

Department Chair: ____________________________________________ Date ______

Please return completed form to:

Office of the Registrar
PO Box 1510
Pembroke, NC 28372-1510

Office Location: Lumbee Hall, Room 133

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