Enrollment Form
The following guidelines are designed to help create a positive, safe, and engaging online learning environment:
I understand that my photograph and comments may be taken and used for publicity purposes. I give permission for my image and statements to appear in local, regional, and statewide publications to help promote the program. I also understand that my comments and photographs may be used in Lowcountry AHEC marketing materials for program recruitment, and that I will not receive any compensation for their use.
By signing, I authorize Lowcountry AHEC to release information from my application and letters of reference as they deem appropriate. I also grant permission for my personal identifiable information to be used for federal, state, and grant tracking and reporting purposes. Additionally, I give explicit permission for Lowcountry AHEC, its regional sites, and other sponsoring agencies to use my image in photography, video, websites, or printed materials.