Authorization to Release Confidential Records
The proponent department is Disability Support Services
DS FORM 2, FEB 2017 Page 2 of 2
Alamo Colleges, Student Success V1.01
I authorize Northeast Lakeview College to request/release the above information. I understand that my
records will be kept confidential and are protected by Federal Regulation/State Law. I also understand that
I may revoke this consent at any time, and that my records will not be released without my signed consent.
24. DISABILITY SERVICES REPRESENTATIVE
The Alamo Colleges District will not discriminate against any employee, applicant for
employment, student or applicant for admission on the basis of race, color, sex, pregnancy,
religion, creed, national origin (including ancestry), citizenship status, physical or mental
disability, age, marital status, sexual orientation, gender, transgender status, gender
identity, gender expression, veteran or military status (including special disabled veteran,
Vietnam-era veteran, or recently separated veteran), predisposing genetic characteristics,
domestic violence victim status, any other protected category under applicable local, state
or federal law, or persons who have opposed discrimination or participated in any
complaint process on campus or before a government agency.. Inquiries or complaints
concerning these matters should be brought to the attention of: Linda Boyer-Owens,
Associate Vice Chancellor of Human Resources and Organizational Development, Title IX/
VII/ADA/504 Coordinator, (210) 485-0200. Address: Human Resources Department, 201 W.
Sheridan, Bldg. A, San Antonio, Texas 78204.