Floral Design Institute, Advanced Wedding Floral Design
Distance Learning Enrollment Agreement
STUDENT'S SOCIAL SECURITY NUMBER______________________________________
Providing your Social Security number is voluntary. If you provide it, your number
will be used for keeping records,
doing research and planning. Your Social Security number will not be given to the
general public. If you choose
not to provide your Social Security number, you will not be denied any services provided
solely under Title 1B of
the Workforce Investment Act. Please read the statement below, which describes how
your Social Security number
will be used. State and Federal Law protects the privacy of your records. The
Workforce Investment Act (WIA) is a
federal law that creates a One-stop system for training and employment services. By
combining employment and
training services at one site, you receive better service. Providing your Social
Security number means that you
consent to use of the number in the manner described.
State rules (OAR 151092909965) authorize Floral Design Institute (a WIA Title 1B
provider) to request that you
voluntarily provide your Social Security number to be used for the following purposes:
1. As an
identification number in maintaining records and
2. As an
identification number for gathering information to be used for program evaluation and
planning, as
required under state and federal law.
The Social Security number you provide could be shared and used by Floral Design Institute
and other organizations
authorized to use such information for the purposes stated above as allowed by the federal
and state laws:
1. WIA
sections 136, 185, 188 (29 USC 2871, 2935, and 2938)
2. ORS
285A.455 and 285A.461
When you allow Floral Design Institute to use your Social Security number, other documents
we have with your Social
Security number on them may be used for the same purposes stated above.
Failure to provide your Social Security number will not be used as a basis to deny you any
service provided under
Title 1B of the Workforce Investment Act. Other programs may request or require you
to give your Social Security
numbers as a condition of obtaining services. They will separately advise you of
this if you apply for their program
As an enrolled student of the Floral Design Institute, I acknowledge that I have read,
understand and agree to
abide by the following: The schools catalogue, The student enrollment agreement, Annual
completion and
placement data is available upon request, The Oregon Revised Statutes and Oregon
Administrative Rules that
govern Private Career Schools available
upon request.
Floral Design Institute, Inc. 1138 NW 17th Avenue, Portland OR 97209, 503-223-8089
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