Rutgers Dual Admission Onboarding Form

Rutgers Dual Admission Onboarding Form
Name*

First NameLast Name
Email*
Date of Birth*

MonthDayYear
Date
Middlesex College Student ID Number
What is your Academic Program*
By signing below, I agree to participate in the Rutgers Dual Admissions program with Middlesex College.*

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STUDENT CONSENT TO RELEASE EDUCATION RECORDS TO RUTGERS UNIVERSITY

The Family Education Rights and Privacy Act of 1974 (FERPA) is a Federal law that protects the privacy of student education records and requires student consent to release non-directory information contained in their education record.

I understand that I was admitted to Middlesex College under the Rutgers University – Middlesex College Dual Admission Program, and under this admission arrangement, my education records will be released to Rutgers University.
I authorize Middlesex College to disclose my education records to Rutgers University as necessary for the purpose of Dual Admission. I understand that this authorization will remain in effect until written notification is received by the Middlesex College Admissions Office requesting termination. *

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