Release of Information:
I am enrolling in an adult education program. This adult education program works with the following programs and agencies to help students improve their skills and earn better jobs:
Other state-funded adult education programs
WorkOne offices and job training programs
Public and Private colleges
State executive offices, departments, and agencies including Indiana Department of Workforce Development (IWD), Division of Adult Education and the Indiana Department of Education, Public Assistance such as TANF and SNAP, and Vocational Rehabilitation
By signing this form, I understand and agree to the following:
DWD use of directory information (name, address, birth, and social security number) to match test score records, wage information, and college/training program enrollment records that assist the state to evaluate and improve its programs and to report results to the federal and state government
The sharing of information between agencies and programs listed above. This information may include my name, enrollment information, education/career goals, test scores, and employment history. The information will be kept strictly confidential and will be used for program administration, research, and evaluation purposes.
Sign your name below.