RELEASE STATEMENT & AGREEMENT
Please read carefully and sign where indicated. Failure to provide a signature will delay processing of the application.
· I certify that the information provided is true and accurate to the best of my knowledge
· I hereby authorize the release of all secondary & post-secondary school records to the Destination College program.
· I authorize Destination College to share and discuss any information with my parents or legal guardians.
· I understand that all information on this application as well as that released from the school will be held in strict confidence by Destination College.
· I give permission to Destination College to take photographs during activities, trips, events and to use my child’s name and/or photo for Destination College educational and/or promotional purposes. *
· Our signatures below indicate our commitment to our child’s education and Destination College.
· I understand TRIO Destination College may contact me or my child by phone call, text, in person or virtually online.
I understand that this authorization remains in effect while a participant in Destination College and through post-secondary education.
I will provide Destination College with written notice to revoke the authorization.