Fillable ExchangeStudentInfo DENTAL HYGIENE SHARED PROGRAM

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ExchangeStudentInfo DENTAL HYGIENE SHARED PROGRAM

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DENTAL HYGIENE SHARED PROGRAM
PERMISSION TO EXCHANGE STUDENT INFORMATION
The Dental Hygiene Consortium requires full exchange of student information so
that the staff responsible to coordinate instruction and services are fully aware of
your progress and needs. Northcentral Technical College and Colby
Community College agree to maintain all shared information confidential. Full
exchange of student information is a requirement for participation in the program.
STATEMENT
I hereby give Northcentral Technical College and Colby Community College
my permission to exchange necessary student data and information in order to
provide instruction and services. This information includes, but is not necessarily
limited to: Test scores, class grades, lab scores, class progress, final class grades,
teacher evaluations, enrollment and registration information, student follow-up
data, student financial aid application, awards, and distribution, if applicable.
__________________________________ ________________________
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ExchangeStudentInfo DENTAL HYGIENE SHARED PROGRAM

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Completed 6 December 2019

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