By completing and signing this form I confirm my participation in the UConn Early College Experience Program, certify that all personal information provided is accurate and will be used to create and/or maintain my University records, and consent to comply with the policies and procedures of the University of Connecticut.

I understand I am serving as the primary contact for UConn ECE information at my high school. As a liaison between UConn and my school, I am familiar with UConn ECE policies and procedures. I will provide reliable program information for interested students, parents, and instructors; manage student registration; be familiar with the billing process and course evaluation procedures; and assist with the UConn ECE class roster verification process.

I understand that my UConn ECE students’ educational records are to be kept confidential under FERPA (Family Educational Rights and Privacy Act), and will be disclosed only with their consent, as the student of record or otherwise in accordance with the University’s FERPA Policy. As a UConn ECE Site Representative, I understand that I must obtain written consent from a student prior to communicating student registration and grade information with a third party, such as a parent or guardian.

Once this form is submitted we will contact you for your social security number so a University account can be created or reactivated for you. Access can then be granted to UConn’s Library resources, e-learning system (HuskyCT), and the Student Administration System where you will have access to view course and student information specific to your high school. Providing your social security number is voluntary; it is not required. If you choose not to provide your social security number, you must disclose if you have previously been affiliated with the University.