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RELEASE OF INFORMATION REQUEST:

The TDLI holds and collects student data for each student in student data files. Under the Protection of Information Act we cannot release this information to anybody but the student themselves.
1. Should you request to have any of your information released, please fill out the request form below, and send it to the TDLI Student Services Advisor.

2. Student Name:

____________________________ Date: _________________

3. Information I would like to be released in an official letter:

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Student Services Advisor Signature:


Date:
TDLI Presidents Signature:


Date: ___________________________________________________

Name and Address to Release Information to:

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

END OF RELEASE OF INFORMATION FORM.