File Transfer Request

This form allows students to grant third parties, including parents, access to their educational records maintained by the student’s college. The Family Educational Rights and Privacy Act of 1974 (Buckley Amendment) prohibits access to, or release of, educational records or personally identifiable information contained in such records (other than directory information) without the written consent of the student, with certain regulatory exceptions. A description of a student’s rights under FERPA is set forth in more detail in the college catalog.

As part of our teach-out plan, we will be providing your academic records and application files to a partner institution if necessary to facilitate your transfer. You may also use this form to request that we provide similar information to a school that is not participating in a formal teach-out plan with NYCDA.

First Name

Middle Name

Last Name

Birthdate

Email Address

Phone Number

In addition to having my student record sent to NYCDA's teach-out partners (AADA, Five Towns College) I approve the transfer of my student records as part of NYCDA's teach-out plan:

Yes

I would like these schools (outside of NYCDA's teach-out partners) to receive my student files:
please include the full name of the college along with city/state
example: New York Film Academy, New York, NY

SIGNATURE:
In lieu of a physical signature, please type your full name