Please contact the Office of Student Scholarships at 317-274-5516 or escholar@iupui.edu if you need assistance accessing this form or to request the form in an alternative format.

I, the undersigned, authorize the IUPUI Office of Student Scholarships to release information regarding my enrollment, academic performance, financial aid awards, scholarship, and bursar account to the Institution/Organization listed below.

This release will be valid for all academic periods in which I am enrolled at IUPUI. I understand that I can revoke this release at any time by notifying the IUPUI Office of Student Scholarships in writing. This request is within compliance of FERPA.