• Student Privacy Rights & Responsibilities
  • Your rights as a student
  • Education records
  • Directory Information
  • Who can access
  • Location of records
  • Problems or questions
  • Invoke privacy form
  • Revoke privacy form
  • Download a FERPA Brochure (PDF)
• FERPA home
• Registrar home
• A-Z index

Family Educational Rights and Privacy Act

Invoke privacy of directory information

Directory Information at Western Michigan University includes the following: student’s name, addresses, phone number, WMU e-mail address, curriculum and major field of study, dates of attendance, degrees/awards received, participation in officially recognized activities and sports, weight/height of members of athletic teams, and the most recent previous educational agency or institution attended by the student.

I understand that by signing this form, any information designated below will be held as confidential by Western Michigan University until I notify the Office of the Registrar in writing that I wish to revoke the Family Educational Rights and Privacy Act.  I do not hold Western Michigan University responsible for list/information already printed, published, or available electronically.

This is to certify that I do not want my address/phone number released for publication.

This is to certify that I do not want Western Michigan University to release ANY information regarding me under the title Directory Information.

Student full name

Western Identification Number (WIN)

 

Signature: _________________________________ Date: ___________

(Print to sign and date)

 

Send or deliver this completed, signed, and dated form along with a copy of your government-issued or WMU student ID to:

The Office of the Registrar Western Michigan University 3210 Seibert Administration Building 1903 W Michigan Avenue Kalamazoo, MI 49008 (269) 387-4300	For Office Use Only
	Processed by: Date: