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Privacy Request to Withhold Directory Information

MISSOURI SOUTHERN STATE UNIVERSITY
OFFICE OF THE REGISTRAR

Under the provisions of the Family Educational Rights and Privacy Act of 1974 (FERPA), as Amended, you have the right to withhold the disclosure of Directory Information.

Directory Information includes: Student’s name, student identification number, address, telephone listing, university e-mail address, place of birth, photograph, major field of study, grade level, participation in officially recognized activities and sports and appropriate statistical data, dates of attendance, enrollment status (full-time or part-time), degrees, honors and awards received, and most recent previous educational institution attended. For the complete list of Directory Information, please visit FERPA Annual Notification.

Please note that invoking this request may lead to some unintended consequences. For example, you may be excluded from public announcements of academic honors and the commencement program. MSSU will also not be able to provide information in response to employment-related degree or enrollment verification inquiries. Any future requests for Directory Information from non-institutional persons or organizations will be denied until a written request is submitted ending this privacy request.

I have read and understand the implications of the Privacy Request to Withhold Directory Information.
*Name: 
*Student ID Number: 
THIS FORM WILL BE MADE AVAILABLE IN ALTERNATIVE FORMATS UPON REQUEST. IF YOU NEED ASSISTANCE, PLEASE CONTACT THE REGISTRAR'S OFFICE at (417)625-9515.
The following information will constitute as an electronic signature.

The username and password are the same as used to log into Lionet.

Username:
(For example, doej001)

Password:
(Pin assigned with your S#)
Username
Password