I hereby request the IUPUI Registrar's Office to remove the RESTRAINT OF STUDENT INFORMATION RELEASE FORM that I filed with that office ____________(date).
I understand (1) that all public information, limited to:
Name
Address
E-mail Address
Major field of study
Dates of attendance
Admission or enrollment status
Campus
School or division
Class standing
Degrees and awards
Activities
Sports and athletic information
Records of arrests and/or convictions
Traffic accident information
will be released freely, and (2) that a copy of this REMOVAL form will be forwarded to my school or division and to other university offices that maintain student records.