Registrar

Registrar

Family Educational Rights and Privacy Act

Revoke 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, I permit Western Michigan University to release all information considered Directory Information until I notify the Office of the Registrar in writing that I wish to invoke the Family Educational Rights and Privacy Act.

This is to certify that I wish to remove my name from the privacy list at Western Michigan University.  I understand that all information considered Directory Information will now be released includes printed and electronic directories.

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:
 
 

Office of the Registrar
Western Michigan University
Kalamazoo MI 49008-5256 USA
(269) 387-4300 | (269) 387-3545 Fax
registrar-info@wmich.edu