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Appendix C: Disclosure Agreement for Student Addresses

The Purdue Alumni Association has access to addresses for incoming and current students who have applied or registered for classes on a Purdue University campus. This information is accessible to the Purdue Alumni Association as a University entity.

Purdue University and Purdue Alumni are required to comply with the Federal Educational Rights and Privacy Act (FERPA), a federal law that, among other things, prohibits widespread disclosure of personally identifiable information, such as student addresses.

Therefore, the alumni club president or a designee must have completed this form prior to requesting data from the Purdue Alumni Association. It can take one to two weeks for the information to be provided to the Purdue Alumni Association once we have made the request of Admissions and/or the Registrar. Once you receive this list, it:

  1. Must only be used for the event/intention for which you requested it (i.e. scholarship information, summer student send-off picnics
  2. Must be used within two weeks of receiving list; otherwise, a new and updated list MUST be requested

As one of the annual requirements to be a club, you must sign this form and return it to the Purdue Alumni Association. You may email to your regional liaison, or mail to:

Purdue Alumni Association Attn: Your Regional Liaison

Dick and Sandy Dauch Alumni Center 403 West Wood Street

West Lafayette, IN 47907-2007


I agree to adhere to the law (FERPA) and respect the privacy, sensitivity, and two-week lifespan of the list provided to me as a representative of the Purdue Alumni Club of: __________________________________________________

Name: _____________________________________   Club Position: _________________________________________________

Address: _________________________________________________________________________________________________

Email: __________________________________________   Phone: ________________________________________________

Date: _______________   Signature: ______________________________________________________