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Directory Information Opt Out Form Template

Protect Your Privacy with This Easy-to-Use Template

If you're concerned about your personal information being publicly accessible, this Directory Information Opt Out Form Template is designed for you. It enables students and guardians to effectively request the removal of their names, addresses, and phone numbers from public directories. By using this straightforward form, you can safeguard your privacy, streamline the opt-out process, and ensure compliance with institutional policies, all while maintaining clear communication with the school or organization. Experience the ease of customizing and using the live template for your needs.

Use this Template (FREE) Live Preview
Full name
Email address
Phone number
Preferred contact method for updates
Email
Phone
Either email or phone
Do not contact me except for required verification
If you are not the person listed, briefly describe your authority to act (e.g., written consent, legal authority)
Relationship to the person listed in the directory
I am the person listed
Parent or legal guardian
Authorized agent or representative
Other
Please Specify:
Directory or website name(s) where the listing appears
Direct link(s) or profile URL(s) to the listing
Scope of this opt-out request
Remove or suppress all directory information about me
Remove my listing from public search results only
Remove specific items only
Other
Please Specify:
If requesting removal of specific items, select the information to remove
Please Specify:
Additional context or instructions (optional)
Is this request urgent?
No
Yes - legal or safety concern
Yes - identity theft or fraud concern
Yes - other
I confirm I am authorized to submit this request for the person identified above.
Yes
No
I understand that identity verification may be required to process this request.
Yes
No
Preferred verification method
Email verification to the address provided
Phone verification (call or text)
I will provide documentation if requested
I understand this opt-out may take time to process.
Yes
No
Typed signature (enter your full name)
Date signed
I understand this request may not affect third-party sites that are not controlled by the directory.
Yes
No
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Paper art illustration depicting a directory information opt out form template for FormCreatorAI article

When to use this form

Use this form when you want to withhold your name, address, email, phone, photo, or other directory details from public release by your school. It helps students, parents, and alumni who value privacy, have safety concerns, or do not want listings in yearbooks, team rosters, or vendor contact lists. Submit it at the start of a term, after a change in circumstances, or before events that publish student lists. Your request flags your record so staff do not disclose these items to outside parties. If you instead need to authorize a specific person to access your records, use the FERPA Waiver form.

Must Ask Directory Information Opt Out Questions

  1. Which directory information items do you want to withhold?

    This clarifies the exact data to suppress (for example, address, phone, photo, majors, honors). It prevents over- or under-blocking and helps staff set the correct flags in your record.

  2. Should this request apply to all future terms or only the current academic year?

    Duration determines when your privacy setting expires and when we prompt you to renew. Clear timing avoids unwanted re-disclosure next term.

  3. Do you allow any limited exceptions, such as commencement programs or athletics rosters?

    Noting narrow exceptions helps honor your preferences while supporting school operations. If you need a one-time release to a third party, submit a Transcript release authorization form.

  4. What is your student ID number and a current contact email?

    We use these to verify identity and confirm when processing is complete. If you also need copies of records for your own use, file a Document request form.

  5. When should this change take effect?

    An effective date ensures we act before publications or vendor lists are finalized. It prevents accidental inclusion in directories already in production.

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