WITHHOLDING OF INFORMATION

  
     
Please fill out, print, sign and mail or fax this form with a copy of your drivers license (request will not be processed without proper ID) To:

San Antonio College Admissions and Records, 1300 San Pedro FAC 216, San Antonio TX 78212. Fax number (210)733-2579.
Last Name First MI
E-mail address   SSN Date of birth
 
I request that the following information not be released except by my written request. I understand that I will be required to show proper ID for any and all requests.
     
  Name Address
  Date of birth Telephone number
  Place of birth Dates of attendance
  Subject major Degrees received and dates awarded
  Previous education institutions Enrollment status

Signature and Date: __________________________________________________________
     

This information will be withheld until you submit a request to release the withholding.
Last updated 9/22/06