Release Directory Information
I want my Directory Information to be released. I no longer wish to prevent the disclosure of my
Directory information and release Our Lady of the Lake University from any responsibility to withhold
Directory Information from the date this form is received in the Registrar’s office. I understand that
removing this hold will remain in effect until I submit a written request to prevent my directory
information from being released. Please note that Directory Information includes but is not limited to
the following: Student’s name, address, telephone number, dates of attendance, class, previous
institution(s) attended, major field of study, awards, honors (including Dean’s List), degree(s) conferred
(including dates), past and previous participation in officially recognized sports and activities, physical
factors (height, weight of athletes), date and place of birth, and photograph.
This form may be faxed, mailed or submitted to the Registrar’s for processing. Your signature
must be provided to release directory information.
Name (Print):_______________________________________
Student ID:____________________ Date:_______________
Signature:__________________________________________
From the date this form is received in the Registrar’s office, we will honor your request to Release
Directory Information.
This form may be mailed, faxed or hand carried to:
Our Lady of the Lake University
Registrar’s Office, 411 S.W. 24
th
St.
San Antonio, TX 78207-4689
Phone: (210) 431-3959
Fax: (210) 436-2314
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