OXNARO COLLEGE EOPS/CARE/CALVVORKS 
WAIVER OF CONFIDENTIALITY 
Pursuant to the Federal Educational Rights and Privacy Act, the California Education Code and the California Administrative Code Title V, the colleges in this district establish and maintain information on students relevant to admission, registration, academic history, career, students benefits or services, extra-curricular activities, counseling and guidance, discipline or matters related to student conduct, and shall establish and maintain such information required by law.
Student records are maintained in a manner to insure privacy of all such information and the colleges of this district shall not, except as authorized, permit any access to or release of any information therein.
In order to help me further my educational and career goals, I am authorizing the Oxnard College Staff to disclose information about me to authorized individuals from other agencies.
I release the right to use my name and photograph for all publications, public information all reports and all press releases relating to Oxnard College and the EOPS/CARE/CalWORKs program.
I give my permission to "Oxnard College Staff" to disclose information about me regarding:
•	Cal WORKs Compliance Issues
•	School Attendance
•	Academic/Progress
•	Assessment Results
•	Child Care Arrangements
•	Work study
•	Verification of TANF Cash Benefits Status and Income
•	Educational Assistance Center (EAC) — assessment results, recommendations, needs and plans
•	Other:____________________________________________________________
To the following persons or agencies:
•	Ventura County Community College District — Staff (VCCCD)
•	Human Services Agency of the County of Ventura (CalWORKs &
•	Mental Health Department
•	Workforce Development Division of the County of Ventura
•	California Employment Development Department
•	Child Development Resources
•	Vocational Rehabilitation Providers
•	Other Educational Providers
•	Other:	

Student's Name:	Student ID #	
	(Print)

Student's Signature:	Date:	

(This waiver shall remain in effect until withdrawn by the student)

Revised: 03/05/10