University of Montevallo
Registrar's Office
75 College Drive
Station 6040
Montevallo, AL 35115
registrar@montevallo.edu
Telephone: (205) 665-6040
Fax: (205) 665-6042

SOLOMON AMENDMENT REQUEST

“The release of directory information without consent shall be limited to legitimate educational purposes or in accordance with the Solomon Amendment.”

Requestor Information

Name:

Email Address:

Organization

Address Line 1:

Address Line 2:

Telephone #:

City:

State:

Zip:

Data Requested

Semester Data is for:

Age Range (must be older than 17):

Class Level:

Select which data should be included in the data file by marking the applicable checkbox.

Student Name:

Student Address:

Telephone Listing:

Email Address:

Date of Birth/Age Range:

Degree:

Academic Major(s):

Class Level:

Signature: ______________________________________________________________

Date:_______________________

Solomon Amendment Request

SOLOMON AMENDMENT REQUEST