Form 1303 - Authorization For Verification Of Attendance For Vocational Education - South Carolina Department Of Social Services
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1
2South Carolina Department of Social Services
AUTHORIZATION FOR VERIFICATION OF ATTENDANCE
FOR VOCATIONAL EDUCATION
Date:
Client’s Name:
SSN: XXX-XX-
Case No.:
Name of Institution:
Address of Institution:
I,
, hereby authorize the South Carolina Department of Social
Services to verify my attendance and any other facts relevant to participation in programs administered by the
Department of Social Services.
Periods to Cover:
-
From
To
I certify that I have read the above statement and understand that this gives my permission for release of such
information.
Client’s Signature:
Date:
DSS Form 1303 (APR 11)
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