Dual Enrollment or Early Admission
Authorization to Release Educational Information
to a Third Party
STUDENT’S LEGAL NAME (print): ___________________________________
I authorize Florida Gulf Coast University to release my academic information to my high
school, school board district and parents while attending Florida Gulf Coast University as a dual
enrolled/early admitted student. I understand this permission form only applies while
attending Florida Gulf Coast University under the status of high school dual enrollment or early
admission.
SIGNATURE OF STUDENT: ____________________________________________________________DATE _______________
Authorized Third Parties:
PLEASE PRINT
HIGH SCHOOL:
________________________________________________________________________
SCHOOL BOARD DISTRICT (County): ________________________________________________________________________
PARENT/GUARDIAN:
________________________________________________________________________
________________________________________________________________________
OTHER:
________________________________________________________________________