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Shippensburg University Office of the Registrar Place or (Shippensburg University of Pennsylvania)

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Country of origin: US
File type: PDF

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Shippensburg University Office of the Registrar
Place or Remove Hold of Directory Information
Please Print:
Name:_______________________________________ S.U. ID.No.:____________________
Last, First
Under the provisions of the Family Educational Rights and Privacy Act of 1974 (FERPA), I am
instructing Shippensburg University to change my preference on the release of my directory information.
By signing below, I understand that the University will place/remove an information hold on my records.
The placement of an information hold on my record indicates that no directory information will be
released to any third parties. The removal of the information hold indicates that directory information
ONLY will be released to any third parties upon request. Directory information includes my name,
address, phone number, email address, enrollment status, major, degree and honors. The hold/release
will remain in effect unless I instruct the University in writing to change my preference on the
release of my directory information. I understand my information remains available to university staff
to be used for official purposes. By choosing to change my preference on the release of my directory
information, I am not giving up my privacy rights as outlined by FERPA.
Check One:
Change my preference to DO NOT RELEASE my Directory Information to any third party.
Change my preference to OK TO RELEASE my Directory Information to any third party.
Signature:______________________________________ Date:________________________
Return the completed form to the Registrar's Office, Old Main 111, email to registr@ship.edu or
FAX to 717-477-1388.
Please click here to view the Family Educational Rights and Privacy Act (FERPA)
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Shippensburg University Office of the Registrar Place or (Shippensburg University of Pennsylvania)

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Completed 26 August 2020

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