Fillable Rogue Community College - Directory Information Request

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Rogue Community College - Directory Information Request

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DIRECTORY INFORMATION REQUEST
revised: 3/19/18
Individual requesting information
Organization
Address
City State Zip
Phone Fax
Reason for request
Directory Information requested for:
Student’s name
RCC ID
Check the information you are requesting:
Address
Telephone number
E-mail address
Major field of study
Dates of enrollment
Degrees received
Additional information requested*
*Additional Directory Information includes participation in official recognized college activities and sports, most recent
previous educational agency or institution attended, academic credit information, photograph, and student ID number.
I agree that I and/or my organization will not forward this directory information to additional outside
organizations, institutions, or agencies.
Signature of Requestor Date
R
CC is an open institution and does not discriminate. For RCC's non-discrimination policy and a full list of regulatory specific contact
persons visit the following webpage: www.roguecc.edu/nondiscrimination.
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Rogue Community College - Directory Information Request

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Completed 4 May 2020

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