40 Avon Street, Keene, NH 03431-3516 | 603-357-3122 | www.antiochne.edu Statement of Confidentiality I, ____________________________________________, Student’s Name – Please Print understand that any information that is made available to me while I am employed by any of the administrative or departmental offices at Antioch University New England will be strictly confidential. __________________________________ Students Signature LOS ANGELES MCGREGOR NEW ENGLAND _________ Date SANTA BARBARA SEATTLE