Request for Confidentiality Status on Student Record
I consent to completing this form electronically.
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Yes
Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Student ID
*
I understand by requesting confidentiality status on my student record, my name will not appear on any requests or College publications, which includes, but is not limited to: information requests, honors listings, programs, etc
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Yes
I understand it will take approximately 5 business days for my request to be processed. If a request for information is received during that time, my information will be shared in accordance with College procedures.
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Yes
I understand that my typed signature (below) will be accepted as an official signature.
*
Agreed
Type a question
Submit
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