THE UNIVERSITY OF MICHIGAN-FLINT
Office of the Registrar
303 S. Saginaw Street, Flint, MI 48502
(810) 762-3344
Confidentiality Agreement
As stated in the University of Michigan-Flint Catalog, directory information under Public Law 93-380,
as amended, includes: Name; home address and telephone; department, class level, and major field;
dates of attendance at the University; degrees received with date, honors and awards; and previous
schools attended. This information is kept in the Office of the Registrar on the University of
Michigan-Flint campus. Currently enrolled students may request that this information be withheld by
completing this form and returning it to the Office of the Registrar. A confidentiality flag will then be
entered into the University student database and all directory information will be kept private.
In addition to the information kept by the Office of the Registrar, a computer directory (called the
X.500) is maintained by the University of Michigan-Ann Arbor. It can be accessed on the Web at
www.umich.edu. Only the student’s name, University email address, and major are listed on the first
page. To view further information a password must be entered. This computer directory will NOT be
affected by signing this form.
Please consider very carefully the consequences of any decision by you to withhold “directory
information”. If you direct the University not to release this information, all future requests for such
information from non-institutional persons and organizations will be refused. Examples: An employer
calls to verify the year and major of a students’ degree for employment purposes; a loan company may
call to verify full-time enrollment for loan purposes, etc.
If you have decided to direct the University to withhold “directory information”, please sign and date
this form and return it to the Office of the Registrar.
I have read this form carefully and understand the consequences of my decision to prevent disclosure of
“directory information”. I understand that this does not prevent disclosure to personnel within the
University who have a need to know consistent with their official duties for the University or to persons
outside the University if such outside disclosure: (1) is permitted by me in writing; (2) is in connection
with my application for or receipt of financial aid; (3) is pursuant to a lawfully issued subpoena; (4) is
required by a health or safety emergency; (5) is otherwise required or permitted by law. (See the
University Policy on Student Records.)
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Name (Please print) SSN/UMID number
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Address
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City, State, Zip
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Signature Date
