FERPA Release Form

Consent to Combine Enrollment Records

 

Dakota College at Bottineau (DCB) provides for the confidentiality of student records in accordance with the Family Education Rights and Privacy Act (FERPA), as amended. Accordingly, in order for DCB to be able to discuss this information with others, including other students, whom you designate, you must authorize DCB to release the following information:

  • Enrollment/Course Rosters

The intent of this consent form is to combine enrollment records, specifically class rosters, for online and on-campus sections of PHOT courses with the same class number and title during the same academic term for the following purposes:

  1. To create an online learning community through which online and on campus photography students can participate in discussions, critiques, and begin to build business contacts and network with other professional photographers who are completing the program.
  2. To enable online students to attend and participate in live video lectures previously only available to on campus students.
  3. To allow online and on campus students access to live video links with guest lecturers.

I, the undersigned, do hereby agree to combine enrollment records, specifically class rosters, for online and on-campus sections of PHOT courses with the same class number and title during the same academic term for the purposed outlines above and for which I am enrolled. The names of the students on the online class roster will be disclosed to students on the on-campus class rosters and vice versa for the purposes outlined above.


 

Check the courses you are enrolled in and for which you willingly agree the release your enrollment data:

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This authorization is not effective until Dakota College at Bottineau receives this signed/dated form.

This authorization will remain in effect until written notification, canceling this authorization, is received by the Student Services Office from the above signed student.

Note: Failure to receive consent from all students enrolled in both the online and on-campus sections of courses with the same title will result in the inability to combine class rosters.

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