Data Privacy Request Data Privacy Request Form Please fill out the form below. Required fields are indicated with a * symbol. Thank you. Requestor Information Full Name * First Name Last Name Email * Phone Number * What is/was your role at Fort Valley State University? * Student Faculty Staff Other Is the name provided above the same as it would be in our records? * Is the name provided above the same as it would be in our records? Yes No Data Privacy Request What is the nature of your data privacy request. * Add Data Change Data Delete Data Other Provide a brief explinantion for your request. * Signature * Clear