Print, complete, sign, and send this form back this form to us at the following address
(you may want to make a copy for your records).

Attn: Alumni Relations/Opt-Out
San Francisco State University
1600 Holloway Ave., Lakeview Center
San Francisco, CA 94132

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(__) NO, please do not share my name, address, and electronic mail address with 
your affinity partners.

Name: _____________________________________________________________

Address: ___________________________________________________________

City, State ZIP: ______________________________________________________

Signature: __________________________________________ Date: ______________________