Office Of The University Registrar
Waiver to Release Educational Records Form
The “Waiver to Release Educational Records” form is to be used by academic or administrative units of the University of Pittsburgh to record the consent of a student to permit the release of protected educational record information to authorized recipients. A copy of this form or a revocation of the waiver must be forwarded to the Office of the University Registrar or Regional Campus Registrar upon receipt, for inclusion in the online student information system and to ensure the University’s compliance with the Family Educational Rights and Privacy Act of 1974, as amended.