Disclosure to Parents Consent Please complete the form below to provide us with your consent. FacebookThis field is for validation purposes and should be left unchanged.This field is hidden when viewing the formWhich form? Disclosure to Parents of Dependent Students and Consent Form for Disclosure to ParentsTo:Registrar, [AIE - Academy of Interactive Entertainment]From:Student Name(Required) First Middle Last Student Permanent Street Address(Required) Street Address City State / Province / Region ZIP / Postal Code Under the Family Educational Rights and Privacy Act (FERPA), the [AIE – Academy of Interactive Entertainment], is permitted to disclose information from your education records to your parents if your parents (or one of your parents) claim you as a dependent for federal tax purposes. Please indicate whether your parents claim you as a tax dependent.Please check the appropriate box:(Required) Yes. I certify that my parents claim me as a dependent for federal income tax purposes. No. I certify that my parents do not claim me as a dependent for federal income tax purposes. Signature(Required)Date(Required) MM slash DD slash YYYY If you are not claimed as a dependent or you do not know whether you are claimed as a dependent for federal income tax purposes, but you agree that [AIE – Academy of Interactive Entertainment] may disclose information from your education records to your parents, please sign the following consent: I consent to the disclosure of any personally identifiable information from my education records to my parent(s), for reasons determined by the [AIE – Academy of Interactive Entertainment] as appropriate. Signature(Required)Date(Required) MM slash DD slash YYYY Parent InformationParent Address(Required) Street Address City State / Province / Region ZIP / Postal Code Parent Cell Phone(Required)Do the parents live at the same address(Required) Yes No Other Parent Address(Required) Street Address City State / Province / Region ZIP / Postal Code Other Parent Cell Phone(Required)By submitting your information you agree to receive communications from AIE about upcoming events, courses and accept AIE's privacy statement. You can unsubscribe at anytime.