Return this form and a picture ID to the Registrar’s Office, Texas Woman’s University, ARB Room 128
Updated 3/26/12
TEXAS WOMAN’S UNIVERSITY
Request to Prevent Disclosure of Directory Information
Directory Information Withhold/Release Form
Withhold Directory Information
I want Directory Information to be withheld. (Directory
Information includes all items listed above.)
I wish to prevent the disclosure of my Directory
Information and understand the ramifications of doing so.
Name (print) _______________________________________
TWU student ID#__________________ Date _____________
Signature __________________________________________
From the date this form is received in the Registrar’s Office,
we will honor your request to Withhold Directory
Information until you request in writing that you wish to
remove the Withhold Directory Information designation. You
may authorize the release of information in writing on a
transaction-by-transaction basis without removing the
Withhold Directory Information designation (see above).
Release Directory Information
I want Directory Information to be released. (Directory
Information includes all items listed above.)
I no longer wish to prevent the disclosure of my Directory
Information and release Texas Woman's University from any
responsibility to withhold open Directory Information from
the date this form is received in the Registrar’s Office.
Name (print) _______________________________________
TWU 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.
Release Directory Information
I want Directory Information to be released. (Directory
Information includes all items listed above.)
I no longer wish to prevent the disclosure of my Directory
Information and release Texas Woman's University from any
responsibility to withhold open Directory Information from the
date this form is received in the Registrar’s Office.
Name (print) _______________________________________
TWU 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.
The items listed under Directory Information may be released in
accordance with the Family Educational Rights and Privacy Act of 1974
(FERPA), as amended. Under the provisions of FERPA, as amended, you have
the right to withhold the disclosure of Directory Information. Please consider
carefully the consequences of any decision to withhold Directory
Information. Should you decide to inform this institution not to release
Directory Information, any future request for such information from non-
institutional persons or organizations will be refused. For example, the
university would be unable to verify degree, major or enrollment for possible
employment, credit card applications, insurance purposes, mortgage
information, apartment leases, etc.
Should you decide to withhold Directory Information, you may
authorize at a later date on a transaction-by-transaction basis the release
of directory or non-directory information (for example, the release of a
transcript for employment purposes) or you may cancel withhold directory.
See below for instructions.
Note to students about to graduate: The withhold directory flag
will remain on your records after graduation if you have requested that the
information be withheld; therefore, we will not be able to verify your
degree to potential employers. (See below for removal of Withhold
Directory Information designation.)
Texas Woman's University will honor your request to withhold the
information listed below but cannot assume responsibility to contact you for
subsequent permission to release that information. Regardless of the effect
upon you, Texas Woman's University assumes no liability for honoring your
request for information to be withheld.
Directory Information includes the following:
•Student’s full name
•Local and permanent address
• TWU e-mail address
•Telephone listing
•Date and place of birth
•Major field of study
•Participation in officially recognized activities and sports
•Weight and height of members of athletic teams
•Dates of attendance
•Enrollment status
•Classification
•Degrees, awards, and honors (including selection criteria)
•Expected graduation date
•Dissertation and thesis titles
•Most previous school attended
•Photograph
This form should be submitted to the Registrar’s Office on or before
the census date of each semester or session. Forms will be accepted
after these deadlines, but we cannot be responsible for the release
of Directory Information prior to receiving the Directory Information
Withhold request in the Registrar’s Office.
