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 the Data Protection Officer of Manchester-Shortsville CSD.
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Email *
First Name *
Last Name *
Phone Number *
Email Address *
Relationship to Student *
Building *
Child(ren)'s Name(s): *
Description of the improper disclosure or breach information: *
Description of Possible Disclosed Data: *
Description of How Reporter Learned of Possible Disclosure: *
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