I authorize the release of my confidential student information (including via fax and email), which may include, but is not limited to, contact information, secondary and post-secondary academic transcripts, college scholarships, financial aid award information from post-secondary institutions, FAFSA completion data, IEPs, standardized test scores, and free/reduced lunch status to GEAR UP Wyoming staff. I also understand that this information may be used by GEAR UP Wyoming staff for the purpose of referral to other state/federal educational programs and services for which I am likely to be eligible, including college-level student success services.

I, as the guardian, authorize the release of the information described above as required for the student to receive GEAR UP Wyoming services and participate in program activities. To the best of my knowledge, I certify that the above student and guardian information is true and correct.

Photographs and videos may be taken of GEAR UP Wyoming participants during activities and may be used for promotional purposes. All photographs and videos are property of GEAR UP Wyoming. All photographs and videos are property of GEAR UP Wyoming. If you do not want photographs or videos of yourself or your student publicized, please initial: