Parent Complaint Form - Student Data Breach
Parents, eligible students (students who are at least 18 years of age or attending a postsecondary institution at any age), principals, teachers, and employees of an educational agency may file a complaint about a possible breach or improper disclosure of student data and/or protected teacher or principal data.  This form is submitted to Robert Blake and Merritt Holly, Superintendent of Le Roy Central School District.
Sign in to Google to save your progress. Learn more
Email *
Your First Name
Your Last Name
Best Phone Number to contact you.
Relationship/Role to Student
Which building is the student in?
Clear selection
Description of improper disclosure or breach information: *
Description of how you  learned of possible disclosure:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Leroy Central Schools. Report Abuse
Google Forms