Carlson College of Massage Therapy FERPA Release

Please fill out the following form to release information to a third party. You will need to pay $7.50 to CCMT (call 319-462-3402 to pay over the phone, send a check or use PayPal) for each transcript.

Please note this $7.50 fee is only for the transcript and regular US mail delivery or scanned/emailed delievery. Should more documents need sent there will be additional fees. If you want the items sent with tracking that is an additional cost as well. ***If email is your preferred method be sure to add the email we are to send to in the COMMENTS section. Additionally we are not responsible for documents sent via email to an unsecured address.

*PLEASE CONSULT the state’s website if you are looking to gain licensure outside of Iowa. It is important you supply us with detailed information including: educational materials they may need, additional forms that need completed or CCMT credentials that need to be included. It is your responsibility to supply this detailed info to us.

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Select what you wish us to include*

Official Transcripts

Grades

Attendance

Progress Report

Warnings

Financial information including Federal Student Aid

Your Name*

Your Email Address*

Your Phone Number*

For the duration of (indicate length of program, if current student):

Name of Institution or business that transcripts or materials are to be sent:*

Contact Person/Authorized person to receive your educational or financial materials as indicated above:

Address*

Street Address City State ZIP Code

Electronic Signature authorizing release of your information (must also call with confirmation):

Date*

Comments

Allow for up to five (5) days for transcripts to be processed and available.

TO complete CLICK ‘SUBMIT’ AND YOU WILL BE RE-DIRECTED TO PAYPAL FOR PAYMENT. if you wish to make payment through paypal complete the transaction there. If not, close paypal out and call us at 319-462-3402 to make payment over the phone.

Carlson College of Massage Therapy FERPA Release

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.​

I, the undersigned hereby authorize Carlson College of Massage Therapy to release the following educational records and information.