GoldStar Program

GoldStar Student Program - Consent and Release Form

Confidentiality Agreement

Purpose. The GoldStar Program is designed to help affiliated businesses (“Affiliates”) connect with candidates for High School Diplomas (“Participants”) throughout the course of the Participants’ final year of coursework. The GoldStar program provide Affiliates with updated, pertinent information regarding its participants a) substance abuse test results, b) records of absences and punctuality, and c) quarterly grade point averages (“GPA”). As part of this certification process, GoldStar will release records to its Affiliates that are confidential in nature, thereby requiring execution of this Confidentiality Agreement (“Agreement”).

Fair Use. At the beginning of each school year, GoldStar will update its records to include the results of each of its Participants preliminary drug tests. At the end of each scholastic quarter, GoldStar will release further information regarding its Participants’ a) quarterly grade point averages (GPAs), b) records of absences and tardiness, and c) latest drug test results. This information is confidential under the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Participants in the GoldStar Program have waived their nondisclosure and privacy rights in this information exclusively for the purposes of recruitment for employment and no other usages are appropriate.

Confidentiality and Non-Disclosure. The Affiliate hereby acknowledges and affirms that it will keep all information given to it by and/or through the GoldStar Program highly confidential, and will only use such information according to the Fair Use provisions contained in Paragraph 2 of this Agreement. The Affiliate furthermore acknowledges and affirms that it will not disclose, publish, share, or otherwise utilize or capitalize upon this information for any purpose other than that set forth in the Fair Use provisions contained in Paragraph 2 of this Agreement.

Term. GoldStar will retain information on its secure password-protected webpage regarding each of its Participants until twelve (12) months following their graduation or until the Participant requests for it to be removed, whichever comes sooner. The Affiliates will have access to information regarding all Participants until this contract is terminated. Upon termination, the strict confidentiality of all Participants’ information will remain in force in perpetuity. Following termination of this Agreement, GoldStar will revoke an Affiliate’s access to the GoldStar database as soon as reasonably possible.

Termination by GoldStar. GoldStar reserves the right to cancel this Agreement at any time if a) it has grounds to suspect that the confidential information of its Participants has been misused by the Affiliate or b) the Affiliate acts in bad faith in any other way relating to the terms, conditions, and circumstances of this Agreement.

Termination by Affiliate. The Affiliate may terminate this Agreement with GoldStar, pursuant to paragraph 5 herein, thirty (30) days after receipt of written notice from Affiliate by GoldStar.

Rates of Use.

Breach. The Parties acknowledge and understand that the information exchanged pursuant to their relationship and the terms of this Agreement is private in nature and could, if improperly used or disclosed, result in substantial damage to the Parties, including possible civil penalties. As such, any party aggrieved by the breach of another to this Agreement shall be entitled to all civil remedies available at law or equity.

SIGNED:

Student Consent

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