Student Privacy Notice

STUDENT PRIVACY NOTICE

Institution Name:

School/District:

Student Information

Student Name:

Date of Birth:    Student ID:

Grade / Program:    Enrollment Date:

Purpose and Scope

This Student Privacy Notice describes the categories of student information collected or maintained by the institution, the purposes for which such information is used, categories of third parties with whom information may be shared, retention practices, and rights available to the student or parent/guardian under applicable federal and state privacy laws. This Notice applies to educational and administrative records created or maintained by the institution.

Categories of Information Collected

Check all categories of information the institution collects, maintains, or discloses in the normal course of the student's enrollment and participation in programs and activities:

Use and Disclosure of Information

Student information is collected and used to support the student's education and safety, including but not limited to: administering instruction and coursework, health and emergency response, school transportation, eligibility determination, reporting to authorized government entities, compliance with legal obligations, and to provide or manage contracted educational and support services. The institution will only disclose student information to third parties when necessary for these purposes or as required or permitted by law.

Categories of third parties to whom information may be disclosed include other schools and institutions for enrollment or transfer, healthcare providers for medical needs, authorized contractors providing educational technology or student services under confidentiality agreements, and governmental agencies for required reporting.

Parental and Student Rights

The parent/guardian of a student or an adult student has the right to: (a) review the student's education records maintained by the institution; (b) request correction of inaccurate or misleading information; (c) request limitations on certain disclosures of personally identifiable information; and (d) receive a copy of this Student Privacy Notice. Requests to inspect, amend, or seek restrictions on disclosures must be submitted in writing to the institution's privacy officer identified below. The institution will respond in accordance with applicable law.

Data Retention, Security, and Transfer

The institution retains student records for the period required by law and institutional policy. Reasonable administrative, technical, and physical safeguards are employed to protect student information from unauthorized access, use, or disclosure. When information is shared, the institution requires reasonable safeguards and contracts that limit use and require return or destruction when no longer needed. In limited circumstances the institution may transfer records in connection with school transfers, legal process, or to comply with lawful obligations.

Emergency and Medical Information

The institution may collect and disclose health and emergency contact information as necessary to protect the health and safety of the student and others. Provide emergency contact and relevant medical information below.

Requests, Complaints, and Contact

To submit a request to inspect or amend records, to withdraw consent where permitted, or to file a privacy complaint, contact the institution's privacy officer:

Acknowledgment and Certification

By signing below, I acknowledge that I have received and read this Student Privacy Notice. I understand the categories of information collected, the purposes for which the institution may use and disclose information, and the rights available to me or to the student. To the extent I have provided consent boxes above, I understand that those selections apply to the categories and purposes described in this Notice. I certify that information provided on this form is true and accurate to the best of my knowledge.

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