╨╧рб▒с>■  /1■   .                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴!` Ё┐Pbjbj\н\н *>╟>╟P       дааааааа┤№ № № №  ┤ ╢ Ж И И И И И И $╜ h%Ьм а м аа ┴ V V V а а Ж V Ж V V ааV  ░I ∙А ╟№ * "V z ╫ 0 V ┴L ┴V ┴аV $ V м м L  ┤┤┤$╪$┤┤┤╪┤┤┤аааааа      AUTHORIZATION FOR THE RELEASE OF STUDENT INFORMATION TO WHOM IT MAY CONCERN: I, _____________________________________, hereby authorize (name of institution) ____________________________________to release and/or orally discuss the education records described below about me to:_____________________________ ______________________________________________________________________ ______________________________________________________________________. The specific records covered by this release are: _________________________ ______________________________________________________________________ ______________________________________________________________________. The persons to whom the information may be released, and their representatives, may use this information for the following purposes: ___________________________ ______________________________________________________________________ ______________________________________________________________________. I understand that the student records information listed above includes information which is classified as private on me under Minn. Stat. з 13.32 and the Federal Family Education Rights and Privacy Act. I understand that by signing this Informed Consent Form, I am authorizing the College/University to release to the persons named above and their representatives information which would otherwise be private and not accessible to them. I understand that without my informed consent, the College/University could not release the information described above because it is classified as private. I understand that when my education records are released to the persons named above and their representatives, the College/University has no control over the use the persons named above or their representatives make of the records which are released. I understand that, at my request, the College/University must provide me with a copy of any educational records it releases to the persons named above pursuant to this consent. I understand that I am not legally obligated to provide this information and that I may revoke this consent at any time. This consent expires upon completion of the above stated purpose or after one year, whichever comes first. However, if the above-stated purpose is not fulfilled after one year, I may renew this consent. A photocopy of this authorization may be used in the same manner and with the same effect as the original documents. I am giving this consent freely and voluntarily and I understand the consequences of my giving this consent. Dated: _____________________________ Signed: ____________________________ 8P№їя hЕ1CJ hЕ15БCJhЕ1678P7 ~ ╞ ╟  [ г д F Н ╒ ╓ ,(Ч+P¤°°°¤є¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤¤dр$a$P■(░╨/ ░р=!░"░#Ра$Ра%░░╨░╨ Р╨ЖЬ8@ё 8 Normal_HmH sH tH DAЄ бD Default Paragraph FontVi@є │V  Table Normal :V Ў4╓4╓ laЎ (k@Ї ┴(No List P     678P7~╞╟[гдFН╒╓,(Ч   + R Ш0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0ААШ0АА678P7~╞╟[гдFН╒╓,(Ч   + R ИН0ИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АИН0АP P P R ╤╪R 33R хЕ1%ФdмR  @А<<Hи╤╤<<P @@  Unknown            GРЗz А Times New Roman5РАSymbol3&Р Зz А Arial"ёИЁ╨hVклFWклFК╞К╞Q#Ёе└┤┤А24K K 2ГЁ▀▀HP)Ё ?ф                     dм2  AUTHORIZATION FOR THE RELEASE System OfficeDorothy Zenner ■ рЕЯЄ∙OhлС+'│┘0ШРШ└╠фЁ№ (4 T ` lxАИРф AUTHORIZATION FOR THE RELEASESystem Office Normal.dotDorothy Zenner 3Microsoft Office Word@дУ╓@\ ╩А ╟@в═эА ╟К╞■ ╒═╒Ь.УЧ+,∙о0 hpАИРШ аи░╕ └ ъфMnSCUK d AUTHORIZATION FOR THE RELEASE Title ■   ■   ■    !"#$%■   '()*+,-■   ¤   0■   ■   ■                                                                                                                                                                                                                                                                                                                       Root Entry         └F░║ ∙А ╟2АData             1Table    WordDocument    *SummaryInformation(            DocumentSummaryInformation8        &CompObj            q            ■                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           ■       └FMicrosoft Office Word Document MSWordDocWord.Document.8Ї9▓q