{"id":210,"date":"2025-04-11T16:26:53","date_gmt":"2025-04-11T16:26:53","guid":{"rendered":"https:\/\/web.saumag.edu\/concurrent\/?page_id=210"},"modified":"2025-04-11T16:38:28","modified_gmt":"2025-04-11T16:38:28","slug":"ferpa-agreement-form","status":"publish","type":"page","link":"https:\/\/web.saumag.edu\/concurrent\/ferpa-agreement-form\/","title":{"rendered":"FERPA &#038; Student-Parent Agreement Form"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/concurrent\/wp-json\/wp\/v2\/pages\/210' data-formid='1' novalidate><div class='gf_invisible ginput_recaptchav3'  data-tabindex='0'><input id=\"input_9e4ac593f2b5cde8e633ad1c4ff5c880\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_9e4ac593f2b5cde8e633ad1c4ff5c880\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_1_3\" class=\"gfield gfield--type-section gfield--input-type-section gsection student-info field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">FERPA - Permission to Release Student Information<\/h3><div class='gsection_description' id='gfield_description_1_3'>The Family Educational Rights and Privacy Act of 1974 is a United States federal law that governs the access to educational information and records by public entities such as potential employers, publicly funded educational institutions, and foreign governments. In short, by completing this form you will permit Southern Arkansas University to share your academic records with parents or family members listed below. <\/div><\/div><fieldset id=\"field_1_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Student Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_1'>\n                            \n                            <span id='input_1_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_1_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_1_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_21\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Student Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_1_21_container'>\n                                <span id='input_1_21_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_21' id='input_1_21' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_1_21' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_1_21_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_21_2' id='input_1_21_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_1_21_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_1_5\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Family Member<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Relationship to Student<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell1 gform-grid-col' data-label='Name'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_1_5\" aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_5_cell2 gform-grid-col' data-label='Relationship to Student'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_1_5\" aria-label='Relationship to Student, Row 1' data-aria-label-template='Relationship to Student, Row {0}' type='text' name='input_5[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_1_5'>If listing multiple contacts, please click the plus icon to the right to add more rows.<\/div><\/fieldset><fieldset id=\"field_1_4\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Family Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_1_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_1_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_1_4_1' value=''    aria-required='true'    \/>\n                                        <label for='input_1_4_1' id='input_1_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_1_4_2_container' >\n                                        <input type='text' name='input_4.2' id='input_1_4_2' value=''     aria-required='false'   \/>\n                                        <label for='input_1_4_2' id='input_1_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_1_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_1_4_3' value=''    aria-required='true'    \/>\n                                    <label for='input_1_4_3' id='input_1_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_1_4_4_container' >\n                                        <select name='input_4.4' id='input_1_4_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' selected='selected'>Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_1_4_4' id='input_1_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_1_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_1_4_5' value=''    aria-required='true'    \/>\n                                    <label for='input_1_4_5' id='input_1_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_1_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_1_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_6'>Parent\/Family Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_1_6' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_1_7\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<\/legend><div class='ginput_container ginput_container_consent'><input name='input_7.1' id='input_1_7_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_1_7_1' >I give permission for the Office of Vice President for Student Affairs to release information about my financial aid, student account, and academic progress to the above person or persons. This release will be valid until rescinded by me.<\/label><input type='hidden' name='input_7.2' value='I give permission for the Office of Vice President for Student Affairs to release information about my financial aid, student account, and academic progress to the above person or persons. This release will be valid until rescinded by me.' class='gform_hidden' \/><input type='hidden' name='input_7.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_1_11\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_11'>Student Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><input type='hidden' value='' name='input_11' id='input_1_11_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_1_11_Container' class='gfield_signature_container ginput_container' style='height:180px; width:400px; ' ><canvas id='input_1_11' width='400' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/web.saumag.edu\/concurrent\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_1_11_toolbar' style='margin:5px 0;position:relative;height:20px;width:400px;max-width:100%;'><img id = 'input_1_11_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_1_11_data' name='input_1_11_data' value=''><\/div><\/div><div id=\"field_1_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection student-info field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Concurrent\/Dual-Credit Enrollment Student &amp; Parent Agreement<\/h3><div class='gsection_description' id='gfield_description_1_8'>Dear Students and Parents:\nTo participate in the Concurrent Enrollment Program (CEP) at Southern Arkansas University, please review the regulations, and sign your name and provide your parent or guardian's email address so that they may sign and approve separately.\n\nIf you have any questions, you can also contact the SAU CEP Coordinator at 870-235-4129 or\nConcurrent@saumag.edu. <\/div><\/div><div id=\"field_1_9\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >  <h2>Students<\/h2>\n  <ul>\n    <li>I understand I must submit my complete concurrent application and meet admission requirements by the date established by my school district and SAU. If I do not, I may not be eligible to participate.<\/li>\n    <li>High School students seeking college credit must complete admission forms each semester and must list their social security numbers. A student\u2019s registration is incomplete until all admissions requirements are met.<\/li>\n    <li>Concurrent high school students are not eligible to enroll in developmental courses in reading, mathematics, and English.<\/li>\n    <li>A student is only allowed to enroll in a maximum of eleven college credit hours per semester.<\/li>\n    <li>All high school students, without exception, must achieve the appropriate assessment test scores to enroll in general education concurrent\/dual credit classes. Students who do not meet the SAU testing score requirements <strong>WILL NOT<\/strong> receive college credit.<\/li>\n    <li>All grades received for college courses will be posted to the student\u2019s college transcript.<\/li>\n    <li>All high school students receiving college credit will be classified as non-degree seeking and will not be eligible for financial aid.<\/li>\n    <li>After enrollment, it is my responsibility to fill out and submit a <a href=\"https:\/\/web.saumag.edu\/admissions\/concurrent-enrollment\/add-drop-form\/\" target=\"_blank\" rel=\"noopener\">drop form<\/a>, if I wish to drop a course.<\/li>\n    <li>For repeated courses, the last grade is the only one that will be used in computing a student\u2019s grade point average.<\/li>\n    <li>I understand if I attend an institution of higher education other than Southern Arkansas University, it is my responsibility to coordinate with said institution the use of the credits.<\/li>\n    <li>I have been advised of the potential limitations of transferring credit to other institutions.<\/li>\n    <li>I understand that, if I choose to enroll in courses, I will earn college credits that will become permanent academic record.<\/li>\n    <li>I understand that the GPA I earn in my college courses may impact my high school GPA, and may also impact my future college admission and federal aid.<\/li>\n    <li>I agree to check my SAU mySAU and Blackboard regularly.<\/li>\n    <li>I understand that if my school district or SAU is paying my tuition and fees and I incur other course related expenses (textbooks, materials), I am responsible for those expenses.<\/li>\n    <li>I have been provided an academic calendar with important semester dates and deadlines. The calendar may be viewed online at <a href=\"https:\/\/web.saumag.edu\/academics\/academic-calendar\" target=\"_blank\" rel=\"noopener\">https:\/\/web.saumag.edu\/academics\/academic-calendar<\/a>.<\/li>\n    <li>I have been provided a Student Handbook and understand I fall under SAU student policies and procedures.<\/li>\n  <\/ul><\/div><fieldset id=\"field_1_10\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Terms Agreement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_10.1' id='input_1_10_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_1_10_1' >I have read and understand the information regarding the SAU Concurrent Enrollment Program and understand the conditions of enrollment and the expectations of my participation in SAU CEP courses<\/label><input type='hidden' name='input_10.2' value='I have read and understand the information regarding the SAU Concurrent Enrollment Program and understand the conditions of enrollment and the expectations of my participation in SAU CEP courses' class='gform_hidden' \/><input type='hidden' name='input_10.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_1_12\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_12'>Student Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><input type='hidden' value='' name='input_12' id='input_1_12_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_1_12_Container' class='gfield_signature_container ginput_container' style='height:180px; width:400px; ' ><canvas id='input_1_12' width='400' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/web.saumag.edu\/concurrent\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_1_12_toolbar' style='margin:5px 0;position:relative;height:20px;width:400px;max-width:100%;'><img id = 'input_1_12_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_1_12_data' name='input_1_12_data' value=''><\/div><\/div><fieldset id=\"field_1_13\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_13'>\n                            \n                            <span id='input_1_13_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_13.3' id='input_1_13_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_13_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_13_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_13.6' id='input_1_13_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_13_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_15\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_1_15_container'>\n                                <span id='input_1_15_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_15' id='input_1_15' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_1_15\" \/>\n                                    <label for='input_1_15' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_1_15_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_15_2' id='input_1_15_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_1_15\" \/>\n                                    <label for='input_1_15_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><div class='gfield_description' id='gfield_description_1_15'>Please make sure this is the correct email address for your parent\/guardian. Upon submission, they will receive an email at this address to view and sign their portion of the student parent agreement. <\/div><\/fieldset><div id=\"field_1_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">Concurrent\/Dual-Credit Enrollment Student &amp; Parent Agreement<\/h3><div class='gsection_description' id='gfield_description_1_16'>Dear Students and Parents:\nTo participate in the Concurrent Enrollment Program (CEP) at Southern Arkansas University, please review the regulations, and sign your name and provide your parent or guardian's email address so that they may sign and approve separately.\n\nIf you have any questions, you can also contact the SAU CEP Coordinator at 870-235-4129 or\nConcurrent@saumag.edu. <\/div><\/div><div id=\"field_1_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  >  <h2>Parents<\/h2>\n  <ul>\n    <li>I am the parent or legal guardian of the below-named student. I hereby consent to his\/her enrollment in the Southern Arkansas University Concurrent Enrollment Program.<\/li>\n    <li>I understand my student is enrolling in a college-level course that will require rigorous academic work and maturity. I understand that SAU is oriented toward serving adults and that class discussions may include adult topics.<\/li>\n    <li>I acknowledge that my student will be subject to the same student standards found in the SAU Student Handbook. A violation may include cheating, plagiarism, and other forms of academic dishonesty. All assignments submitted must represent his\/her own work, ideas, concepts, and current understanding or must cite the original source. Academic dishonesty includes assisting a student to cheat, plagiarize, or commit any act of academic dishonesty. Academic dishonesty may be cause for failure in the course and\/or dismissal from the Concurrent Enrollment Program.<\/li>\n    <li>I understand that my student will be graded on a college-level grading standard, and the grade he\/she receives will become part of their permanent record and be maintained in the Registrar\u2019s Office.<\/li>\n    <li>SAU credits are transferrable to most public colleges and universities. I understand that my student is responsible for verifying that credits will transfer to his or her selected college and how they will apply to a chosen degree program.<\/li>\n    <li>Under the Family Educational Rights and Privacy Act (FERPA), I will not have access to the academic records of my student without his\/her written consent.<\/li>\n    <li>I understand that if my student participates in a class campus visit, photographs, video, and audio recordings may be taken. I give permission for these photos to be used by the Concurrent Enrollment Program in brochures, websites, and other promotional materials.<\/li>\n    <li>I understand that should it be necessary for my student to withdraw from a concurrent credit course, it is my student\u2019s responsibility to follow all the SAU guidelines for withdrawal. I understand that withdrawal from the high school class does not automatically withdraw the student from the SAU course.<\/li>\n  <\/ul><\/div><fieldset id=\"field_1_18\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >Parent\/Guardian Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_18'>\n                            \n                            <span id='input_1_18_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_18.3' id='input_1_18_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_18_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_18_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_18.6' id='input_1_18_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_18_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_1_20\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >Terms Agreement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_20.1' id='input_1_20_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_1_20_1' >I have read and understand the information regarding the SAU Concurrent Enrollment Program and understand the conditions of enrollment and the expectations of my student\u2019s participation in SAU CEP courses.<\/label><input type='hidden' name='input_20.2' value='I have read and understand the information regarding the SAU Concurrent Enrollment Program and understand the conditions of enrollment and the expectations of my student\u2019s participation in SAU CEP courses.' class='gform_hidden' \/><input type='hidden' name='input_20.3' value='1' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_1_19\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_1_19'>Parent\/Guardian Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><input type='hidden' value='' name='input_19' id='input_1_19_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_1_19_Container' class='gfield_signature_container ginput_container' style='height:180px; width:400px; ' ><canvas id='input_1_19' width='400' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/web.saumag.edu\/concurrent\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_1_19_toolbar' style='margin:5px 0;position:relative;height:20px;width:400px;max-width:100%;'><img id = 'input_1_19_resetbutton' 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