Revocation of Confidentiality/Directory Exclusion
This form is to be used to remove a previously requested Confidentiality/Directory Exclusion and allow SUNY Cobleskill to release
directory information from our student record in accordance with the Federal Family Rights to
Privacy Act of 1974 (FERPA). SUNY Cobleskill has designated the following as Directory Information:
Campus, local and home
Dates of Attendance
Dates of Graduation
Date of Birth
No other student information is released to non-university personnel without written permission.
Additional information on FERPA and related policies can be found in the student handbook under Important Policies or on the
Registrar’s Office webpage.
Student ID (or Social Security) Number Contact Phone
By signing below, I hereby authorize SUNY Cobleskill to remove the
Exclusion block from my student
Student Signature Date
Requests will be honored within 4 business days of receipt.
Completed forms must be presented in person, with appropriate identification, or mailed to SUNY Cobleskill, Office of the Registrar,
Knapp Hall 101, State Route 7, Cobleskill, NY 12043.
Requests received by mail must be notarized or they will not be processed.
Notary Public’s Signature Date