ATTACHMENT C
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B. ________ I want my prior instructions not to release directory information withdrawn.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
