Paris Junior College-EOC-Release of Information Form

RELEASE OF INFORMATION

Please complete the following form to allow TRIO EOC access to necessary records to help meet your educational needs.

To contact our TRIO EOC, email at trioeoc@parisujc.edu or call 903-782-0353.

Name*

First NameLast Name

Other Names Used:

Social Security Number*

999-99-9999

Date of Birth*

mm-dd-yyyy

E-mail Address*

example@example.com

By electronically signing your name below, you give the TRIO Educational Opportunity Center authorization to collect records deemed pertinent for providing assistance with your educational needs towards enrollment in postsecondary education and hereby absolve both institutions/agencies of any liability in acting on this request to release the desired information.

PARTICIPANT SIGNATURE*

DATE*

mm-dd-yyyy


Pell
SEOG
Stafford


Scholarships
WIA/JTPA/BIA
Vocational Rehabilitation


Work-Study
Perkins
Plus