Rowe Scholars Records Release Name* First Last StudentAdmin ID Number*The seven digit number, no letters.UConn school(s)/college(s) enrolled in* CAHNR CLAS Fine Arts ACES Business Pharmacy Engineering Neag Nursing Major(s)* E-mail address* Cell phone number*(# # #) # # # - # # # #I authorize the University of Connecticut ("UConn") to release my transcripts, demographic information, biographic information, and financial aid information to UConn employees (beyond those engaged in teaching and necessary administrative functions) for purposes of research, evaluation, and improvement of the Rowe Scholars Program. I also authorize UConn to release the above mentioned records to the Donors of the Rowe Scholars Program for the purpose(s) of updating the Donors about program health and status. I understand that (1) I have the right not to consent to the release of my education records; (2) I have the right to receive a copy of such records upon request. This information is released subject to the confidentiality provisions of appropriate state and federal laws and regulations which prohibit any further disclosure of this information without the written consent of the person to whom it pertains, or as otherwise permitted by such regulations. By typing my name, I am electronically signing this form and agree to all of the above statements.*SignatureDate* MM slash DD slash YYYY CAPTCHANameThis field is for validation purposes and should be left unchanged.