Authority to Release Information

Authority to Release Information

Authorise Asset College to share your personal information with a third party
First Name*
Surname*
Date of Birth*

DayMonthYear
Phone Number*
Email*
Authorisation for Release of Information

I, {firstName} {surname} (student name), hereby authorise Asset College (RTO Number 31718) to release my enrolment and training records, including but not limited to enrolment records, attendance details, academic progress, assessments, qualifications, and competencies achieved, to the third party(ies) listed below. This authorisation is provided in accordance with the Australian Privacy Principles (APPs) contained in the Privacy Act 1988 (Cth) and the Asset College Privacy Policy.
Third Party Details
Organisation
Contact Person*
Address
Phone Number*
Email*
Disclosure Details
Duration of Authorisation (unless revoked earlier in writing)*

For 30 days onlyIndefinitelyOther
Purpose of Disclosure
Conditions or Limitations
Specify any additional instructions for Asset College releasing information (eg. release specific documents only).
Student Declaration
- I understand that my records are protected under the Australian Privacy Principles and cannot be disclosed without my written consent, except where authorised or required by law.
- I acknowledge that I have the right to request a copy of the information released and to withdraw this authorisation at any time by providing written notice to Asset College.
- I certify that the information provided in this form is true and correct and that I fully understand the terms of this authorisation.
{firstName} {surname}
Signature*

Clear
Date*

DayMonthYear
Should be Empty:

Authority to Release Information

Authorisation for Release of Information

Third Party Details

Disclosure Details

Student Declaration