Revoke Restriction of Student Directory Information Request Form

Revoke Restriction of Student Directory Information Request Form
Completed form will be submitted digitally to the Registrar's Office for processing. Effective date of this request is the day it is processed.
Name

First NameMiddle InitialLast Name
I am requesting that the Office of the Registrar remove the confidentiality code that is on my student record.
Student's Signature

Clear
Date

MonthDayYear
Date
Should be Empty: