TO:

ECE Tutors, TAs and Graders

RE:

Employee Confidentiality Statement and Records Release Authorization

STUDENT ID# 818200654

The information provided below is intended to insure that all ECE student employees are aware of certain
policies that affect those hired for educational purposes (i.e. not RAs). Please complete all items on this form
and if TA, return to Colleen Sweeney, Graduate Administrative Assistant, in the ECE office. Tutors and
Graders should return their forms to Shannon Cotter, Undergrad Administrative Assistant, in the ECE office.

General Information
Name: ______Manik Jahagirdar__________ email: mmjahagirdar@wpi.edu

Date:10/26/2015

Please print name

Phone: (774) 701 - 9817

Circle One:

Tutor Grader

TA

Academic Standing
A student employed by the ECE department as a TA, Tutor or Grader, and who does not maintain good
academic standing may be removed from ECE employment.

Code of Conduct
Violating the WPI campus code of conduct while a TA, Tutor or Grader, described at:
http://www.wpi.edu/Pubs/Policies/Judicial/sect4.html may result in removal from an ECE Tutor, TA or
Grader position.

Academic Honesty Certification

I certify that I have never been involved in an academic honesty case that resulted in sanctions against me.
_________ Date: 10/26/2015
Student Signature

Records Release
By signing below, you are authorizing the WPI Office of Student Life to release any records of judicial
proceedings resulting from violation of the WPI campus code of conduct.
______________________________________________ Date: 10/26/2015
Student Signature

Confidentiality
As a TA, Tutor or Grader employee of the ECE department, you may have access to confidential information
such as grades, student records, test results, student progress in class and similar data. You may also have verbal
communication with instructors and students which must be kept confidential. To accept employment is to
accept responsibility to preserve the confidentiality of this information. Failure to adhere to these guidelines will
result in the termination of employment.
I have read the above employee confidentiality statement. I understand and accept my responsibility to preserve
the confidentiality of student and WPI information.
______________________________________________ Date: 10/26/2015
Student Signature