ࡱ> &% \p Karen DIxon Ba==,8X@"1Arial1Arial1Arial1Arial1Univers1Univers1Univers1Univers1Univers1Arial1Arial1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)                + ) , *     (    (  (  ( @  (  (  ( "8  (@ "8@ "8  (@  (@    (@@  (@ "0 !8@ "0  "8  "8  "8  "8 "8@  "8  "8  !8  "8@  !8 !8 "8`@ "0`  "8`  "8`  !8 0@ 0 0 8@@  8@  8 @  8@  8  8  "8@@  "8@  "8 @  "8@ 8@@ 8@ 8 @ 0@ 0 0 "8@ "8 "8 "8@ "8 "8 "8@@ "8@ "8 @ `Sheet1v&Sheet2}'Sheet38%"(DATA REQUIRED BY THE PRIVACY ACT OF 1974 AuthorityPrincipal Purpose Routine Uses DisclosurePREVIOUS EDITIONS ARE OBSOLETEGFor use of this form, see CC Pam 145-4, the proponent agency is ATCC-PC#20 USC 1232g, and Public Law 93-380Disclosure is voluntary. gHaving been advised of the provisions of Public Law 93-380 (20 USC 1232g, Family Educational Rights andXPrivacy Act of 1974) and in connection with my participation in the Army ROTC program, I(Cadet's Name)) hereby authorize the release of any and'all official records maintained by the (Name of School)Uor it's ROTC Department to personnel in the Department of Defense and/or my parents, (Name of Parents).fI waive any requirement that I be furnished a copy of those records prior to or concurrent with their brelease. This consent remains effective until my relationship with the ROTC program is terminated.ZTo provide authorization/declination to release information contained in official records.Signature of CadetDate7AUTHORIZATION/DECLINATION FOR ACCESS TO STUDENT RECORDS4PART I - AUTHORIZATION FOR ACCESS TO STUDENT RECORDS;PART II - DECLINATION OF PARENTAL ACCESS TO STUDENT RECORDSaAlthough informing my parents of the academic/ROTC progress made by me may assist in my quest to [become a commissioned officer, I decline to allow release of official records maintained by ROTC Department to my rparents. (Exception: Parents who still claim student as a dependent for IRS purposes) If I change my mind in the V5future, I will inform the ROTC Department in writing.CC FORM 137-R, AUG 02YTo authorize/decline the release of any and all official records maintained by the ROTC DDepartment to personnel in the Department of Defense and/or parents.* SP qcc  :%  dMbP?_*+%&?'?(?)?M\\CCSVR_03\PA_HLPDK_4050w odXXXJAPD dTimes New RomanH "dXX??U} $ :                                 %&&&&&&&& MNNNNNNNNO PQQQQQQQQR  STTTTTTTTU  ! "  "   " ! "    "      G HHHHHHHHI  JKKKKKKKKL :;;;;;;;;< #  #  #    C FFFFF 2***** ( '''))  ''' DDDDDE  '''+++++, ('''*****- ('''*****- .)))/////  3 CDDDDDDDD1 2++++++++1 ('''*****- ('''*****-  '''*****- Dl***>>4>>***4**4***** ! " # $ %  & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9  '''*****- ! '''*****- " '''*****- #.)))//*//0 $($'''*** $4 $*- %5666777778 &=&>>>>>>>>? '@AAAAAAAAB ( '''*****- )()'''*****- *(*'''*****- +('''*****- ,.)))/// ,9 ,*- -C-DDDDDD**- .2++++++**- /(/'''*****- 0(0'''*****- 1 '''*****- 2 '''*****- 3 '''*****- 4 '''*****- 5 '''*****- 6.)))//*//0 7(7'''*** 74 7*- 8 9$ 9 98@***4***@>'@ J     &' -- 7  .'  dMbP?_*+%" ?? U>@7  5(  dMbP?_*+%"?? U>@7 Oh+'0HPl Elaine Krzanowski Karen DIxonMicrosoft Excel@?B5M@'8@U)}՜.+,0 PXd lt| --- Sheet1Sheet2Sheet3  Worksheets  !"#$Root Entry Fh"x>Workbook(SummaryInformation(DocumentSummaryInformation8