Skip navigation

HERE2ODU (ODU Mobility Pass) Opt-in and Release Form

Name(Required)













MM slash DD slash YYYY

Select One
Yes
No
Enter Mailing Address Below(Required)







Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific





FERPA Statement

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C.& 1232g: 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education. In accordance with FERPA, it is the policy of TCC amd ODU to withhold certain educational records unless the student provides consent to disclose information. The purpose of this form is to provide the consent to TCC and ODU required by FERPA.

I, the undersigned, hereby understand and authorize TCC and ODU to release/discuss educational records and information and agree to my student records being shared between the two institutions for the purpose of credit evaluation to award any degree, diploma, or certificate, if I am eligible to graduate.

This release does not permit the disclosure of these records to any other persons or entities without my written consent or as permitted by law. This release form is effective from the date of submission and consent remains in effect until receipt of written revocation.

Response Required:(Required)