TEXAS A&M UNIVERSITY-TEXARKANA

Request to Prevent Disclosure of Directory Information


* denotes required information
Student Information
     
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Under the Family Education Rights and Privacy Act of 1974 (FERPA), the following information is designated as directory information and may be made public unless the student requests to restrict this information. The information may be provided to Texas A&M University-Texarkana officials and other specified individuals as prescribed by FERPA:

Full NameAddresses (local, permanent)University Email
PhotographTelephone (local, permanent)Date/place of birth
MajorFull or Part Time StatusDates of Attendance
Enrollment StatusDegrees and awards received
Most recent previous educational agency or institution attended
Participation in officially recognized activities and sports


Select one of the following:

  Restrict Directory Information (This restriction does not expire unless it is revoked in writing)
  Remove Directory Information Restriction

I understand this request supersedes any previously
Submitted requests for directory information restrictions or releases.

Be advised that restricting certain directory information such as your name, major, and degrees received will prohibit any release of information regarding your attendance at Texas A&M University-Texarkana unless you revoke this restriction in writing. This could prevent you from receiving enrollment verifications or could prevent potential employers from receiving valuable hiring information, etc.


Signature

 By checking this box, I understand that this will serve as my electronic signature.



State law requires that you be informed of the following: (1) you are entitled to request to be informed about the information about yourself collected by use of this form (with a few exceptions as provided by law); (2) you are entitled to receive and review that information; and (3) you are entitled to have the information corrected at no charge to you. For more information see our Privacy Statement.