Return to: UCA Financial Aid Office, 201 Donaghey Avenue, 001 McCastlain Hall, Conway, AR 72035 FAX: 501-450-5159 Phone: 501-450-3140 RELEASE OF STUDENT INFORMATION AUTHORIZATION FORM (RIA) (Act 605 of 2009) A student who receives any form of state-supported student financial assistance, as defined by Act 605 of 2009, must sign this form indicating whether he/she authorizes the Department of Higher Education and/or the University of Central Arkansas to release his/her individual personal information listed below to the Bureau of Legislative Research. (If a student is under the age of eighteen years old and is not legally emancipated, a parent or legal guardian shall complete and sign the authorization form.) For each student who authorizes the release of his/her individual personal information, the Bureau of Legislative Research will receive the following information: 1.A unique student identifier; 2.Status for Federal Pell grant; 3.Postsecondary grade point average; 4.Number of semester hours attempted; 5.
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Legislative Research, Student Financial Assistance, Bureau of Legislative Research, individual personal information