Postsecondary Enrollment Options Program

CONSENT FOR RELEASE OF CONFIDENTIAL INFORMATION

I, ___________________________________________________________________________, do hereby consent to and authorize

Mesabi Range Community & Technical College counselors to release the following information to my parents or legal guardian.

• academic progress / grades
• attendance
• comments / concerns expressed by professors
• semester progress reports

DATE OF BIRTH:

SIGNATURE:

DATE:

This consent allows the release of this information during any semester of enrollment at a postsecondary enrollment options student.