BELOIT COLLEGE REQUEST TO PREVENT DISCLOSURE OF DIRECTORY INFORMATION

Beloit College defines Directory Information as:

Name, address (local and permanent), telephone number (local and permanent), email address, dates of registered attendance, major field of study, degrees and awards received, participation in officially recognized activities and sports, weight and height of members of athletic teams, the most recent previous educational institution attended, and enrollment status (full-time/part-time).

Directory Information may be released for any purpose at the discretion of the institution.

Under the provisions of the Family Educational Rights and Privacy Act of 1974, as Amended, you have the right to withhold the disclosure of any or all of the categories of Directory Information.

Please consider very carefully the consequences of any decision by you to withhold Directory Information. Should you decide to inform the institution not to release Directory Information, any future requests for such information from non-college persons or organizations, including prospective employers, will be refused.

The institution will honor your request to withhold any of the categories listed below but cannot assume responsibility to contact you for subsequent permission to release them. Regardless of the effect upon you, the institution assumes no liability for honoring your instructions that such information be withheld.

To request that the college withhold the release of your Directory Information, please print this form using your browser’s print option, sign, and date it, and submit it in person to the Beloit College Registrar’s Office or by email to registrar@beloit.edu from your Beloit College email account.

I understand that by signing this form I am instructing Beloit College NOT to release ANY Directory Information.

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