To be completed by the Student & Parent/Guardian.
I hereby authorize the of release transcripts, grades, progress reports, standardized test scores (included but not limited to EOC, MAP, ACT, SAT, PLAN, PSAT scores, & National Student Clearinghouse), attendance records, conduct and behavior reports, and other educational information to the Upward Bound Program at Avila University. In addition, the Upward Bound staff may meet with my student at school as necessary to discuss academic and personal issues. I also give Upward Bound permission to use the participant’s photo for advertising and social media purposes in regards to the program.
By signing this, I understand that all information gathered will be kept strictly confidential and will not be communicated to any other person(s) or organization(s). I authorize the Upward Bound Program at Avila University to request and obtain these documents for as long as necessary for federal reporting purposes.