Office of Nationally Competitive Scholarships Applicant Permission Form and Waiver

Applicant Permission Form and Waiver

By my signature below, I acknowledge that my reputation and the reputation of the University can benefit from the manner in which I represent myself and Colorado School of Mines through the fellowship, scholarship and grant application process and through any award that results from that process. I will do everything in my control to safeguard my good name and that of Mines throughout the award competition. 1) As required under the Family Educational Rights and Privacy Act, or FERPA, I hereby grant permission for my grade point average (GPA), transcripts and course work to be shared and discussed as a part of faculty and institutional letters of recommendation, endorsements and applications for all award competitions, internal (Mines) and external (national selection committees). I also give permission for the Office of Nationally Competitive Scholarships to request unofficial and official copies of my transcript(s) as needed for the application process. 2) I waive my right to view faculty and institutional letters of recommendation or endorsement written for my applications. I understand that copies of these letters may be provided to me by the authors, but that this gesture is an independent courtesy extended by the author and does not affect this waiver. (optional) 3) I grant permission for Mines to use my biographical information and likeness or image to publicize my nomination and/or receipt of any fellowship, scholarship or grant. I also consent to have a copy of my application and all supporting materials retained indefinitely by the Office of Nationally Competitive Scholarships and understand that it may be made available to future applicants (with my and name and personal information redacted) as an example for them to review as they prepare their own application. 4) I certify that all of the information I include in my applications, including listings of activities and awards, research undertaken or planned, and personal statements and other essays, are my own work and are accurate and honest to the best of my knowledge. 5) I give permission to the Colorado School of Mines Registrar or its designees to release to the Office of Nationally Competitive Scholarships all information pertaining to academic honesty and violation of conduct policies. The Registrar may also provide contextual information about the severity of these offenses. This information may be shared in verbal or written form. This consent will remain in effect until revoked by me by written letter to the Office of Nationally Competitive Scholarships. Such revocation will not affect disclosures made prior to this action.

By my signature below, I acknowledge that my reputation and the reputation of the University can benefit from the manner in which I represent myself and Colorado School of Mines through the fellowship, scholarship and grant application process and through any award that results from that process. I will do everything in my control to safeguard my good name and that of Mines throughout the award competition.

1) As required under the Family Educational Rights and Privacy Act, or FERPA, I hereby grant permission for my grade point average (GPA), transcripts and course work to be shared and discussed as a part of faculty and institutional letters of recommendation, endorsements and applications for all award competitions, internal (Mines) and external (national selection committees). I also give permission for the Office of Nationally Competitive Scholarships to request unofficial and official copies of my transcript(s) as needed for the application process.

2) I waive my right to view faculty and institutional letters of recommendation or endorsement written for my applications. I understand that copies of these letters may be provided to me by the authors, but that this gesture is an independent courtesy extended by the author and does not affect this waiver.

(optional) 3) I grant permission for Mines to use my biographical information and likeness or image to publicize my nomination and/or receipt of any fellowship, scholarship or grant. I also consent to have a copy of my application and all supporting materials retained indefinitely by the Office of Nationally Competitive Scholarships and understand that it may be made available to future applicants (with my and name and personal information redacted) as an example for them to review as they prepare their own application.

4) I certify that all of the information I include in my applications, including listings of activities and awards, research undertaken or planned, and personal statements and other essays, are my own work and are accurate and honest to the best of my knowledge.

5) I give permission to the Colorado School of Mines Registrar or its designees to release to the Office of Nationally Competitive Scholarships all information pertaining to academic honesty and violation of conduct policies. The Registrar may also provide contextual information about the severity of these offenses. This information may be shared in verbal or written form.

This consent will remain in effect until revoked by me by written letter to the Office of Nationally Competitive Scholarships. Such revocation will not affect disclosures made prior to this action.

By checking this box and writing my name and date below, I agree to the following Permission Form and Waiver

I would like to opt out of #3 above - I do not want my name to be publicized if I am selected

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