Fillable Privacy Form Privacy Form Privacy Form.pdf (Winthrop University)

Fill Online, Printable, Fillable, Blank Privacy Form Privacy Form Privacy Form.pdf (Winthrop University) Form

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Privacy Form Privacy Form Privacy Form.pdf (Winthrop University)

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WINTHROP UNIVERSITY
OFFICE OF RECORDS AND REGISTRATION
PRIVACY REQUEST FORM
_______________________________ _________________________
Student Name Student ID
I wish to place a privacy block on my record. I understand that none of the
following information can be released outside the University:
Name Enrollment Status
Local Address Dates of Attendance
Permanent Address Classification
Telephone Number Major
Winthrop Telephone Directory Class Schedule
Degrees Awarded Photograph
E-Mail Address Gender
Graduation Program/Lists Previous Institution Attended
Vendors (Graduation and Other) Awards and Honors
Parents' Names Sports Participation
Parents' Address Weight/Height of Athlete
Date/Place of Birth
Requests to remove information from the online directory must be made to the IT
department, 15 Tillman, or online at the Student Directory page.
_________________________________ _____________________________
Student signature Date
Return form to:
Office of Records and Registration, 126 Tillman Hall, Rock Hill, SC 29733
Fax 803-323-4600
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Privacy Form Privacy Form Privacy Form.pdf (Winthrop University)

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Completed 20 July 2020

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