Additional required occi forms
Health Risk and Liability Acknowledgement form
The Health Risk and Liability Acknowledgement form must be on file for each student prior to registering for upper tier courses. The form must be signed by student in front of a notary public and must have a visible seal or notary stamp for it to be accepted. The student need only complete this form one time. Students may mail, fax, or email the completed form using the contact information at the bottom of this page.
Health Risk and Liability Acknowledgement
Facility FERPA form
All students must complete and submit a FERPA form granting program staff permission to discuss their coursework with the personnel at each of their OCCI sites. The Form to be completed by student naming each OCCI site with which the student is associated.
Facility FERPA Form
CONTACT INFORMATION FOR OCCI SUBMISSION
Pat Roach: email@example.com or (505) 566-3843
Cindy Painter: firstname.lastname@example.org or (505) 566-4047
San Juan College VTDLP
Pat Roach, Rm 1113
Farmington, NM 87402
For more information, please call Sherry Hair, Program Advisor at (888) 313-3838.
Or send us an email at email@example.com.