Nina Mason Pulliam Charitable Trust Scholarship

Consent to Release Records

The federal Family Educational Rights and Privacy Act (FERPA) protects the privacy of educational records that the university maintains about me. By signing below, I give permission for ASU or the ASU Foundation to disclose to the donor and any review committee the information provided in connection with this scholarship application for the purpose of review of my application, and the administration and promotion of the scholarship program. This may include information from my educational records, such as my official transcript, letters of recommendations, and financial aid information. This permission is granted for each semester I am awarded a scholarship from the Nina Mason Pulliam Charitable Trust.

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Student Name    

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Anticipated graduation date

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Student Signature

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Date