Request for Report

Submit SIGNED request to:

Mrs. Sylvia Wynne

JSU Box 17147

Phone: 601.979.2615 Fax: 601.979.9307

For office use only Researcher Assigned


Include the following information (if appropriate for your request):

NOTICE: The information contained in this report of student information may contain personally identifiable information that is legally protected by the Family Educational Rights and Privacy Act of 1974 (FERPA). All University employees who access this information must make every effort to store student data in secure and confidential environment. Only administrators, faculty and staff employed by Jackson State University who demonstrate a genuine need to know based on a legitimate educational interest may have access to a student's record. A legitimate educational interest will be limited to an interest arising from the faculty/staff member's fulfillment of his/her assigned responsibilities, and disclosure will be limited to such information is necessary to fulfill those responsibilities. The contents of this report should not be shared with anyone who does not have a legitimate, demonstrated need to know the information contained herein. Official student, program, college, department, faculty, and staff statistics should only be obtained and released with guidance from the Department of Institutional Research, Planning, and Assessment. Once you have completed use of this information for the purpose described above, it should be destroyed.