Education Digital Process Form

EDUCATION DIGITAL PROCESS FORM

Institution Identification

Institution Name:

Institution Address:

Student Information

Parent / Guardian (if student is minor)

Is the student a minor? Yes

Program & Enrollment Details

Program Start Date:    Anticipated End Date:

Full-time    Part-time    Remote / Online    Hybrid

One-time payment    Installment plan    Number of installments:

Digital Process Authorization

By executing this form, Student/Guardian authorizes Institution to create, store, access and process educational records and administrative documents in electronic form. Authorized electronic actions include but are not limited to: electronic assignment submission, digital grade reporting, electronic billing, electronic signatures on institutional documents, and secure exchanges with authorized third-party vendors engaged to support educational delivery.

Institution Name: is authorized to rely on electronic records and electronic signatures provided by the Student/Guardian and to treat such electronic records and signatures as legally binding.

Data Privacy, Access, and Retention

Student/Guardian acknowledges that electronic records will be stored on Institution systems and on third-party platforms retained by Institution under contractual terms that include confidentiality and data security obligations. Institution will maintain educational records in accordance with institutional retention schedules. Student/Guardian retains the right to request access to electronic records and may submit a written request to Institution to correct inaccurate information; Institution will review requests and respond in accordance with established institutional procedures.

Consent to share directory or non-sensitive academic information with third parties for educational purposes (check if you consent):

Acceptable Use & Device Responsibility

Student/Guardian agrees to abide by the Institution's acceptable use policies for hardware, software, network access, and learning platforms. Student/Guardian is responsible for maintaining up-to-date software and securing personal credentials. Institution is not liable for loss or damage to student-owned devices; Institution may provide loaner equipment subject to separate terms.

I acknowledge responsibility for device maintenance and secure use (check to acknowledge):

Electronic Communications & Signatures

Student/Guardian consents to receive official communications such as billing, academic notices, schedules and disciplinary communications electronically to contacts provided herein. Student/Guardian also consents that electronic signatures executed in connection with this form and subsequent institutional documents are legally binding.

Consent to electronic communications:    Consent to electronic signatures:

Policy Acknowledgments

By signing below, Student/Guardian affirms that they have read and accepted the following institutional policies (check each to acknowledge):

Academic Integrity Policy    Privacy and Records Policy    Attendance and Participation Policy

Student Code of Conduct    Acceptable Use Policy for IT Resources

Emergency & Medical Information

Certification and Legal Acknowledgment

I hereby certify that the information provided on this form is true and correct to the best of my knowledge. I understand that unauthorized alteration of electronic records is prohibited and may result in disciplinary action. I acknowledge that Institution may take reasonable measures to verify identity for electronic transactions and that falsification of documents may subject the Student/Guardian to institutional or legal consequences.

Withdrawal of consent for electronic processing must be submitted in writing to Institution; withdrawal does not retroactively invalidate records already lawfully processed under this authorization.

Optional Notices

If a third party payer (employer, sponsor) will be invoiced, provide payer name and billing contact below.

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