! For!Office!Use!Only!__________!
Background: Family Educational Rights and Privacy Act (“FERPA”) requires that the College, with few exceptions, obtain a
student’s written consent prior to disclosing to a third party any personally identifiable information about that student. However, the
College may disclose information designated as “directory information” without prior written consent of the student, unless the
student Opts Out of Directory Information disclosure by filling out this Form. Directory Information is generally considered
information that is not harmful or an invasion of privacy if released.
Nassau Community College has designated the following items as Directory Information:
a student’s name,
Student’s NCC ID Number,
mailing address,
major field of study,
enrollment status (full-time/part-time),
dates of attendance,
degrees being pursued,
participation in College sports and/or activities,
weight and height of members of athletic teams, and
degrees, honors and awards received.
The main purpose of designating the above information as “directory” is to permit the College to include this information in certain
publications, such as: listing your name on the graduation program, submitting your awards and accomplishments for publication in a
local newspaper, or printing your name in a playbill should you participate in a theater production on campus. The College does not
release any directory information to commercial entities seeking to conduct solicitations or fund-raising activities.
NEGATIVE CONSEQUENCES OF OPTING OUT: Students who choose to restrict access to their Directory Information should be
aware that doing so may result in unintended negative consequences. For example, organizations such as potential employers,
scholarship agencies, members of the press, loan agencies, educational organizations and others will not be given access to the
student’s directory information, and will not be able to contact the student. Opting out of directory information classification may
mean that you may miss out on valuable employment, educational, cultural and other opportunities.
Should you wish to Opt Out of Directory Information Disclosure, fill out and submit this form to registrar@ncc.edu.
Student’s Name _______________________________ NCC-ID ______________________
I hereby request that my information remain confidential. I choose to “OPT OUT” of having
my directory information released to any third party without my written consent, except as
required by law. I have read and understand the information provided above and the potential
consequences for making this request. My dated signature below confirms my opt-out request.
_________________________________________________ ______________________
Student’s Signature Date