Oregon State University

Ex4: Authorization to Release Student Employment Information

Student Employment Policy & Procedure Manual
Section 100: Introductory Material
Revised: 08/01/2005

 

I, ___________________________________________________________, OSU ID Number,

________________________, give (department/unit name), _____________________________________

of Oregon State University permission to release employment information about me for the following dates:

__________________ to __________________________________ OR while employed in the

position of ________________________________________________________.

 

_______________________    _______________________
Signature                                    Date

Send original document to the Office of Human Resources, 204 Kerr Administration Bldg.

Office of Human Resources
204 Kerr Administration Bldg.
Corvallis, OR 97331
Phone (541) 737-0908

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