I have read this form, and, to the best of my knowledge, the information I have provided is true and correct. I agree to enroll and participate as a student in Central Florida STEM Alliance for the National Science Foundation’s Louis Stokes Alliances for Minority Participation (LSAMP) Paths to Engagement Program at Pasco Hernando State College. I agree to remain in good standing with the program by meeting the participation requirements for my level of engagement each semester I am enrolled. This participation agreement shall remain in effect for the period specified below.
In accordance with Pasco Hernando State College policies and procedures, as well as state and federal law (including the Family Education Rights and Privacy Act and Florida Statutes Section 1002.225), I freely and voluntarily consent to Pasco Hernando State College’s disclosure and release to the National Science Foundation of any and all my education records for the purposes of the B2B Program. I further consent to my education records being disclosed by, between, and among Pasco Hernando State College, the Florida Institute of Technology, and any other institutions participating in the Central Florida STEM Alliance that have executed a data sharing agreement, for the limited purpose of both institutions’ research and reporting obligations as defined by LSAMP. This consent shall remain in effect for the period specified below.
I understand that the information disclosed and released to the National Science Foundation is required under the terms of the grant award. This information will be used to evaluate the progress of and outcomes for individual program participants, as well as to assess implementation effectiveness and overall program impact and success. I also understand that LSAMP Program staff may discuss my academic and personal needs with other college staff as needed to assist me in my educational goals and progress for the purposes of the LSAMP Program.
