
NortheasternOklahomaA&M College
RequesttoKeepDirectoryInformationConfidential
(forcurrentlyregisteredstudents)
Please returnthecompletedand signedform totheAdmissions/Registrar’sOfficeat200I
StreetNEBox3843,Miami,OK 74354;918‐542‐9759(fax)or neoadmission@neo.edu.
Print Name: CWID:
(Last) (First) (MI)
Email: Phone #:
Pleasemarktheinformationyou doNOTwanttobereleasedas“directory”informationto
thirdparties:
o
Nameofstudent
o
Localaddressandzipcode
o
Localtelephonenumber
o
Emailaddress
o
Majorfieldofstudy
o
Educational level(freshmanorsophomore)
o
Datesofattendance
o
Enrollmentstatus(full‐timeorpart‐time)
o
Degree awarded
o
Dean’sorPresident’sHonorRoll
o
Mostrecenteducationalinstitutionattended
o
Participationinofficiallyrecognizedactivities andsports
o
Personalstatisticsformembers ofathleticteams(heightandweight)
o
Photographs
Torevokethisrequest, Imustdosoinwriting.
Signature: Date:
Registrar UseOnly:
DateReceived:
DateProcessed:
Processedby:
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