13.2 The City University of New York Directory Information Non-Disclosure Form
DIRECTORY INFORMATION NON-DISCLOSURE FORM
This form must be filed with the Registrar’s Office if you do not wish directory information to be disclosed without your prior consent (see the University’s definition of directory information below.) Directory information otherwise may be made available to any parties to whom the University wishes to provide it. The instructions on this form may be changed at any time by filing a new form with the Registrar’s Office. You should initial the appropriate spaces.
Name of student: _____________________________________________
Student ID number: __________________________________________
A. _____ I DO NOT WANT DIRECTORY INFORMATION DISCLOSED WITHOUT MY PRIOR CONSENT. (If you initial this space you do not have to fill out the rest of this form, but must date and sign below.) B. ______ I want my prior instructions not to release directory information withdrawn. I now authorize the college to release my directory information.
Dated: __________ Signed: _______________________________
Directory information consists of a student’s: (a) Name; (b) Address; (c) email address; (d) Telephone number; (e) Attendance dates (semesters and sessions, not daily records); (f) Photograph; (g) 8-digit student ID number (but only if the identifier cannot be used to gain access to education records except when used in conjunction with one or more factors that authenticate the user’s identity); (h) Enrollment status (full or part-time, undergraduate or graduate, etc.); (i) Level of education (credits completed); (j) Degree enrolled for and major field of study; (k) Participation in officially recognized activities and sports (teams); (l) For members of athletic teams only, height and weight; (m) Degrees, honors and awards received. Address, email address and telephone number may be released only to employees of the University and its constituent colleges for the purpose of conducting legitimate University business. They may not be shared with individuals and organizations outside the University.
CUNY Office of the General Counsel July 2019