Prepare | Eastern Maine Community College

Bruce White, Electricians Technology

Student Testimonial

“I had the chance to go to school after I was laid off from Dexter Shoe. I surprised myself by how well I adapted to classroom learning after 20 years out of school. I’ve made the Dean’s List and will graduate in May. I’m proof it can be done!”

Prepare

Are you ready to apply to Eastern Maine Community College? Have you double- and triple-checked what you need to collect, complete, and submit? Dig into this section for more details on things you may be missing, like Criminal Background Check, Transfer Credit, Immunization, and Placement Testing.

Student Consent to Release Information

If you would prefer to fill this form out by hand, please fill out this PDF and mail or fax it to the following address:
Office of Registrar
Eastern Maine Community College
354 Hogan Road, Bangor, ME 04401
Fax: 207.974.4683

You can also scan it and email it to registrar@emcc.edu
If you have any questions about the form, please call 207.974.4613

Student Consent to Release Information

In compliance with the Family Educational Rights and Privacy Act (FERPA) of 1974 as Amended, Eastern Maine Community College will not release student grades, schedules, or financial aid information to parents, spouses, or others, unless written permission is given by the student.

Name*
First Last
EMCC ID Number*
Student's Date of Birth (MM/DD/YYYY)*
By signing this form, I authorize the appropriate offices or personnel at Eastern Maine Community College to release information regarding my Educational Records which include: Academic, Financial Aid, Billing, Student Employment and EMCC Student Code of Conduct information. Under no circumstance, will the college release any medical information. The College may share Educational Records with those people who claimed you on last year’s income tax returns, regardless of permissions granted in this form.
Provide first and last name and 4 digits of the social security number of the parent(s), guardian, spouse or others that you wish to grant permission to:
Example: Jane Smith, XXXX Joe Smith, XXXX
This authorization may be revoked in writing at any time. Otherwise it will remain in effect during my enrollment at Eastern Maine Community College.
Your Name*
First Last
Today's Date*
MM slash DD slash YYYY
Email*
Consent*
I consent
By entering my name, date, and EMCC email, I understand that this acts as my electronic signature.
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