Authorization to Release Information | Student Affairs and Campus Diversity | SDSU

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Authorization to Release Information

Fill out and print the form below or download and print the form (PDF).

Name

Address

Phone

Name

Address

Phone

Student Name

Red ID

Signature

Date

Once you have completed this form in its entirety, , SIGN IT, and deliver it to Student Services West, Room 1604 or mail it to:

Center for Student Rights and Responsibilities
San Diego State University
5500 Campanile Drive
San Diego, CA 92182-7443