Request to Prevent Disclosure of Directory Information

In accordance with the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g; 34 CFR Part 99, students may request that the institution not disclose directory information without prior written consent.

Directory information includes, but is not limited to:

• Name
• College Email Address
• Major/Field of Study
• Participation in recognized activities or sports
• Weight and height of members of athletic teams
• Dates of Attendance
• Degrees and Awards Received

By signing this form, I request that John A. Logan College not disclose any directory information to non-institutional persons or organizations. Examples of non-institutional entities include commercial vendors, media outlets, and external recruiters.

I understand that:

• This request remains in effect until I submit a written revocation to the Office of Admissions and Records.
• This request does not prevent the release of information otherwise required by law,
• such as in response to a subpoena or court order, as permitted under FERPA (34CFR
• § 99.31(a)(9)).
• Withholding directory information may have unintended consequences, such as
• exclusion from college publications or verification services.

Please complete the following:

Full Name: *

First

Last

Student ID Number: *

Email *

Email

Confirm Email

Request *

• I request to prevent disclosure of my directory information.

ID Number: Name:

Signature *

Clear Signature

Submit