Participant’s Signature. Date: *Must be at least eighteen 18 years old of age Parent's signature: Date: (if student is under 18 years of age): Student or Participant’s Full Name _ _ • I authorize employees, agents, and representatives of the University of the Incarnate Word (UIW) and the host institution abroad to release to the United States Government and to the host institution abroad, and their employees, agents, and representatives, information in the possession of UIW regarding my location, status, welfare, intentions, or problems. • I further authorize UIW to release to those persons named below, information in the possession of UIW regarding my location, status, welfare, intentions, or problems. • I grant permission to the officials of the University of the Incarnate Word to provide copies of written records, permit inspection and review of the contents of my education records, and/or to discuss my academic performance in connection with my student organization international activity, program and/or excursion with the following person(s) as authorized by the Federal Educational Rights and Privacy Act.
Appears in 3 contracts
Sources: Participation Abroad Agreement, Participation Abroad Agreement, Participation Abroad Agreement