Electronic Signature: I declare under penalty of perjury that the information on this form is true to the best of my knowledge.
Information Release: Pursuant to 20 USA 1231a of the U.S. Department of Education, PJCEOC is authorized to access information deemed necessary to assist me in achieving my educational goals or in meeting the reported requirements of the U.S. Department of Education, to record pertinent facts regarding my eligibility in the program, services rendered, and post-secondary education enrollment. This information is protected by the Privacy Act, kept confidential and not be seen unless specifically authorized. A copy of this statement shall serve as such authorization. I allow personnel to conduct and communicate information pertaining to my educational outcomes as they relate to the EOC project using phone, email, text messaging or other digital mediums.
For dependent students under the age of 18, EOC requires a parent/guardian signature to authorize the information on this application. An EOC staff member will assist you with this when appropriate.