Request to Prevent Disclosure of Directory Information Form

Under the provisions of the Family Educational Rights and Privacy Act of 1974, you have the right to withhold the disclosure of Directory Information.

Please consider very carefully the consequences of any decision by you to withhold any category of Directory Information. Should you decide to inform SUNY Empire not to release any of all of this information, any future requests for it from noninstitutional persons or organizations will be refused.

For the period of one year, regardless of the effect upon you, SUNY Empire assumes no liability for honoring your instructions that such information be withheld.

Request to Prevent Disclosure of Directory Information (PDF 124kB)

(You will need Adobe Acrobat Reader to use this file. If you are unable to open this file, please contact us at RegistrarsOffice@SUNYEmpire.edu for assistance.)

Please check the appropriate line(s) and affix your signature on the form to indicate that the college cannot disclose the following public or Directory Information. Active students must submit this form to the Office of the Registrar by:

U.S. MAIL
Office of the Registrar
Empire State University
111 West Avenue
Saratoga Springs, NY 12866.

Or

FAX
518 580-0105