UNIVERSITY OF MINNESOTA, CROOKSTON CAMPUS
REQUEST TO SUPPRESS PUBLIC INFORMATION
First, please read the following paragraph. Then, if you still wish to suppress public information, check one box
below and return the completed form. You may complete this form on the Web (at
http://onestop.umcrookston.edu/). Go to the section called “Update or Suppress Personal Information”.
The University of Minnesota has designated some information about you as public information. This information
includes: name, address, e-mail address, phone number, dates of enrollment, enrollment status, major, adviser,
college, class, academic awards and honors, and degrees received. This means that the University can release this
information to anyone who requests it. You have the opportunity to suppress parts or all of this information from
public release.
Suppression might have undesirable consequences. With some options, individuals at the University might be
unable to contact you about assignments, or you might not receive notice of some services. Suppression does not
limit access to your file by authorized individuals nor does it apply to employment information. Information can be
released by subpoena, to parents of dependent children with appropriate documentation, etc. The following five
options are available for suppression; please choose one:
Suppress my phone number from the directory.
Suppress my address from the directory.
Suppress my address and phone number from the directory.
Suppress my address, phone number, and e-mail from the directory. (No information about you will appear in the University’s
electronic directory or in the next edition of the printed directory, and your address, phone number, and e-mail address will not be
released to third parties.)
Suppress all information about me. (No information about you will be released to third parties without your signature. The fact of your
attendance will not be released; prospective employers, financial institutions, or others offering services will be unable to have the
University verify your attendance.)
Remove suppression. (Any current suppression will be removed.)
last name(s)
first name(s) middle name
ID number
social security number (last 4-digits) date of birth
Signature
today’s date
SUBMIT TO:
Office of the Registrar, University of Minnesota, Crookston, 9 Hill Hall, 2900 University Ave., Crookston, MN 56716-5001
The University of Minnesota is an equal opportunity employer and educator.
