Please fill out this online form, print (using "Print Form" button at bottom of page), sign and:
112 Shields Building
University Park, PA 16802
The following items of information regarding a student's record are considered directory information. Directory information is considered as public information and may be released without the student's prior consent.
Filing this form will preclude the University from releasing directory information to anyone (including yourself) without express written consent. To process this request you must present this form along with photo identification to any campus Registrar's office or mail this form along with a copy of photo identification to the address listed above
I have read this form carefully and understand the consequences of my decision to prevent release directory information. I understand: