DIRECTIVE REGARDING DIRECTORY INFORMATION

Under the University's Fair Information Practices Regulations, I have the right to 
request that certain personal information, which is regarded by the University as 
"Directory Information," not be disseminated to other than University personnel or 
where required by statute, court order, or legitimate University purpose.


I hereby direct that the following information regarding me not be disseminated 
as "Directory Information":


(Please check each area to be restricted)

__________Home Address                  __________Social Security Number

__________Home Telephone Number         __________Marital Status

__________Date and Place of Birth       __________Citizenship

__________Education                     __________Other(Specify)_______________________






    DATE_______________                PRINTED NAME_____________________________________



    EMPLOYEE ID__________________         SIGNATURE________________________________________




Please complete and return this form to the Human Resources Information Center, 
3rd floor, Whitmore Administration Building even if you do not desire to restrict 
any category of information.