I-BEST Application

Please use your legal name. We are not able to register students who use alternative or preferred names.

The Washington State Board for Community and Technical Colleges pursuant to RCW 28B.50.090, authorizes BC to ask you for your social security number. The number will be used for keeping records, research on students in general and summary reporting. Your number also will be provided to the SBCTC, who gathers information about students and programs to meet state and federal reporting requirements. It also helps to plan, research and develop programs. This information, which includes employment and wage information held by the Employment Security Department, helps to support the progress of students and their success in the work place and other educational programs. When conducting research, your number will only be disclosed in a manner that does not permit personal identification. Your social security number will never be used to report personal information. By providing your number, you are consenting to these uses as identified. Provision of your SSN and consent of its use is not required and, if you choose not to do so, you will not be denied any right benefit or privilege provided by law. You may revoke your consent for the use of your social security number at any time. I certify to the best of my knowledge that all answers on this form are true. Completion of this form authorizes BC to release my name, address, phone numbers, and/or email to other institutions of higher education that may only use it to mail me information.

I, the undersigned, consent to each and every use by Bellevue College, and all of its officers, employees, and agents of 1) each photograph, videotape or other likeness of me taken/recorded on (date) and/or 2) comments provided in interviews on (date) and/or in writing. Such uses may include, but are not limited to, every use in a publication, newspaper, advertisement, web site, videotape presentation, television show or other publication or recording. I also waive any right to compensation for such uses, or to inspect or approve the uses beforehand. I release Bellevue College, its legal representatives and all persons acting under its permission or authority, from any liability for any blurring, distortion, alteration or optical illusion that may occur with these pictures. I, the undersigned, consent to each and every use by Bellevue College, and all of its officers, employees, and agents of 1) each photograph, videotape or other likeness of me taken/recorded on (date) and/or 2) comments provided in interviews on (date) and/or in writing. Such uses may include, but are not limited to, every use in a publication, newspaper, advertisement, web site, videotape presentation, television show or other publication or recording. I also waive any right to compensation for such uses, or to inspect or approve the uses beforehand. I release Bellevue College, its legal representatives and all persons acting under its permission or authority, from any liability for any blurring, distortion, alteration or optical illusion that may occur with these pictures.

I agree to be bound by the terms of this Electronic Consent Agreement with the Photo Release Policy and Permission to use your SSN Policy. I also consent to the use of electronic signatures in place of written documents and handwritten signatures and to electronic communications.

Bellevue College does not discriminate on the basis of race, color, national origin, language, sex, sexual orientation, including gender identity or expression, disability, or age in its programs and activities. Please see policy 4150 at www.bellevuecollege.edu/policies/. The following people have been designated to handle inquiries regarding nondiscrimination policies: Title IX Coordinator, 425-564-2641, Office C227, and EEOC/504 Compliance Officer, 425-564-2178, Office R130.