authorize the Chanellor of the Ohio Department of Higher Education to release my educational records, which includes my name, social security number, student ID number and date of birth, to the agencies listed below. The agency use of these records is limited to and in connection with the audit and evaluation of Federally supported education programs, or in connection with the enforcement of the Federal legal requirements, that relate to such programs.
Ohio Department of Job and Family Services, 30 East Broad Street, 32nd Floor, Columbus, OH 43215
High School Equivalence Diploma
Ohio Department of Education, 25 South Front Street, Columbus, OH 43215
Education Outcomes for students co-enrolled
Opportunities for Ohioans with Disabilities, 400 East Campus View Blvd, Columbus, OH 43235
My signature is acknowledgement that I have read and voluntarily consented to the release of the above mentioned education records as collected and utilized by the Aspire program I have previously enrolled or tested with.
*Use of Social Security number is optional. If you choose to give us your Social Security Number, we will use it to maintain your file and assure prompt and accurate reporting.
** Students under the age of 18 must have this consent form signed by the student’s parent or guardian.