Alaska SEED Registry Release of Information 


To translate the form into Spanish or another language (Para traducir el formulario al español u otro idioma):
  1. Open the form using Google Chrome web browser. Download Chrome here. (Abra el formulario con el navegador web Google Chrome. Descarga Chrome aquí.)
  2. Anywhere on this form, right click and you will see a drop-down menu. (En cualquier lugar de este formulario, haga clic con el botón derecho y verá un menú desplegable.)
  3. Select “Translate to …” (Selecciona "Traducir a ...".)
  4. Choose the language you would like it to be translated to. (Elija el idioma al que le gustaría que se tradujera.)
  5. Repeat steps 2-4 on each new form page. (Repita los pasos 2 a 4 en cada nueva página de formulario.)
Agreement
I,
(Name of person authorizing release of information), Authorize the mutual exchange of information below between the Alaska SEED Registry and  
(Name of person authorized to receive information).
Please initial the information you are authorizing Alaska SEED to share with the above named individual:
SEED Registry Username
(Initial)
SEED Career Ladder Level
(Initial)
SEED Registry Membership Expiration Date
(Initial)
Number of Annual Training Hours Achieved
(Initial)
All information is confidential and may only be shared between the above indicated parties. If you have any questions, please contact Alaska SEED at 907.265.3194 or info@seedalaska.org.

I acknowledge this agreement is valid for twelve months from the date signed. I further agree that if I leave my place of employment before the twelve-month period ends, it is my responsibility to notify the Alaska SEED Registry that this agreement is revoked/null and void.

Instructions to Sign and Submit Your Release of Information

To submit and complete this form, follow these steps:
  1. Click “submit” button below. This will take you to the signature page. 
  2. On signature page, please sign at the bottom of the page. 
  3. Click “submit signed response” button on signature page. This will submit your signature and send you an email to verify your signature. 
  4. Open verification email. 
  5. In verification email, click the link in the email to complete the signature process. Important note: Your release of information will not be submitted until this step is complete.