Untitled Header Image
 

Student Grant FERPA Permissions and ID Verification

indicates a required answer

This form is to be completed by the STUDENT.
1. *

Student First Name
2. 

Student Middle Name
3. *

Student Last Name
4. 

Suffix
5. *

Email Address
6. *

List the first and last name of the person to whom you are giving FERPA permissions.
7. *

What is this person's relationship to you?
8. *

Address (line 1)
9. 

Address (line 2)
10. 

Address (line 3)
11. *

City
12. *

State
13. *

Zip Code
14. *

Country
15. *

Permission Start Date 
16. *

Permission End Date
17. *

Should this person be granted permission to view your student-related information?
Yes No
18. *

Should this person be granted permissions to view your financial information?

 
Yes No
19. *

Should this person be granted permissions to view your academic information?  
Yes No
20. *

Please provide a Personal Identification Number (PIN) or Password that Love First Homeschool Inc. will use to authenticate those whom permission has been granted.  This PIN/Password will be used to verify all inquiries for your student account.  It is the responsibility of the Student to provide the PIN/Password to the person whom permission has been granted.
21. *

Please upload a photo or scan to verify you identification.  A driver's license, photo ID, or birth certificate are acceptable.

Allowed extensions: csv, doc, docx, dot, gif, heic, heif, htm, html, jpeg, jpg, m4a, mov, mp3, mp4, pdf, png, pps, ppt, pptx, pub, rtf, svg, txt, xls, xlsx, yyz, zip