Page 89 - MMI Cadet Manual SY2017.18

OFFICE OF THE COMMANDANT
MARION MILITARY INSTITUTE
MARION, ALABAMA

DRUG, ALCOHOL, AND SUBSTANCE ABUSE SCREENING PARTICIPATION
FORM/ NOTICE OF FEDERAL STUDENT FINANCIAL AID PENALTIES

I understand that my enrollment as a student at Marion Military Institute and a member of
the Marion Military Institute (MMI) Corps of Cadets is contingent upon practicing and
participating in a Drug-Free lifestyle. I acknowledge that information pertaining to the Institute’s
Drug and Alcohol Awareness Program as well as policies and procedures pertaining to the use,
possession or sale of illegal or controlled substances can be referenced in Chapter 11 of the MMI
Cadet Manual. I also understand that additional information concerning MMI’s drug and alcohol
policies can be referenced through the cadet health center as well as section 3.2 of MMI’s
Faculty and Staff Handbook.

Commensurate with MMI’s policies and procedures pertaining to the use, possession, or
sale of illegal or unauthorized drugs, I hereby consent to participate in drug screening or testing
as directed by MMI’s President, Executive Vice President, Vice President for Student Affairs
and Commandant of Cadets, or any other designated representative(s) of the Institute. Drug
screening and testing may include, but is not limited to breath testing, urinalysis and hair follicle
samples. I understand that a positive finding will result in dismissal from Marion Military
Institute’s Corps of Cadets as specified in Chapter 8 of the MMI Cadet Manual.

I also acknowledge that a criminal conviction for any offense, during a period of
enrollment for which I receive Title IV, HEA program funds, under any federal or state law
involving the possession or sale of illegal drugs will result in the loss of eligibility for any Title
IV, HEA grant, loan, or work-study assistance (see HEA sec. 484r (1); (20 U.S.C. 1091r(1).

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PRINT NAME
(Last, First, MI)

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DATE

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CADET SIGNATURE

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