RTEC 101 FERPA release form

Reserve your RTEC 101 Spot!

 You will need to have an active L# and we can either register you for the course or you can in your myLane. Registration is required before the first day. You will have an opportunity drop without penalty during the first week if you no longer want to participate. It is important to register before the first day so your Moodle account can be personalized with advising information and you can complete the first week activities before their deadline.

You need to tell Lane if we're allowed to communicate directly with your high school or district. Without your permission, Lane and the RTEC 101 instructor cannot release any student information due to the Federal Education Rights and Privacy Act (FERPA).

Tell us about yourself
An L# is required to register for any Lane class. If you don't already have one, I will send you an email on how to get your L# and register for this class.
Students under 18 when the class starts will need their parents to sign a consent form. I will verify with Enrollment Services to see if you have already completed this step. If you have not, the RTEC 101 instruct will email you the form. You can email a picture of it back to me.
Fall and Winter terms are all online through Moodle. Students will be taught how to use Moodle on the first day zoom meeting
Registration is required before the first day of class. Students who do not participate during week 1 will be dropped from the course.
Your myLane password is needed to access myLane, Moodle and your student email address. You need your password before the first week.
This will reserve your spot for this class. The class is for the first 20 students and then a wait-list will begin. First come, first serve
Please write out your HS name If you are in a GED program at your high school, please write GED and your high school's name If you are a HS/GED graduate wanting to take summer term, write graduate
Optional Acknowledgement and Release of Information

Sharing of student information between school district staff and Lane Community College staff requires a release of student record information, which is covered by the Federal Educational Rights and Privacy Act (FERPA). If you choose to release your information, it will be in effect until you graduate high school and only the HS Connection Office will know if you signed this form. 

I understand the following
  • I authorize the release of myLane’s financial aid requirements and award letter to High School Connections to ensure my academic eligibility for financial aid after graduation.
  • I understand that all policies regarding grading, class attendance, college deadlines, payments on account and college procedures apply to me and exceptions will not be made because of my age or status as a dual enrolled high school student. I will be expected to use myLane to make adjustments to my schedule, review and access my Account Summary for any charges assessed, and review my unofficial transcript, which will reflect my grades.I will not give out myLane password to anyone.
  • I am choosing to complete college-level course content. Classes may be a blend of underage and adult high school students (age 18-21), which creates an adult-oriented learning environment. I recognize that course content, instructor focus, and class discussions will not be amended to account for my age. Lane staff expects mature, adult behavior and may provide follow-up on non-attendance or feedback back on academic progress only to the student, unless the student releases information.
  • Students will sign a registration commitment form on the first day of class if they want to formally register in the course. Enrollment Services will assist with registration. Students will be responsible to use myLane to drop or grade change RTEC 101 by the college deadlines.
  • Grades earned in RTEC 101 will appear on my permanent college transcript. The grade will not be eligible for adjustment at a later date and will impact future financial aid and/or Academic Progress Standards.
  • The Family Educational Rights and Privacy Act (FERPA) is a Federal law that protects the privacy of student education records. Regardless of age, you, the student, can choose if you want to release information to your high school and/or parent/guardians See Lane's FERPA policy for more details
  • This FERPA release, if approved, is only granted to the High School Connections office. Any parent or high school employee contacting other Lane departments will not be given information about myLane account.
Your signature

By entering in my name, and personal email, I certify that I have read and agree to the HS Connections RTEC 101 referral form and if applicable, release of my information. I have provided complete and accurate statements on this form. I will obtain a copy and print for my records.