Fillable Confidentiality Agreement Form (University of Dayton)

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Confidentiality Agreement Form (University of Dayton)

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The Confidentiality Agreement Form (University of Dayton) form is 3 pages long and contains:

  • 2 signatures
  • 9 check-boxes
  • 34 other fields

Country of origin: US
File type: PDF

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UD Username:
UD ID Number:
Questions? Contact the UDit IT Risk Management Office at (937) 229-4387 or itriskmgmt@udayton.edu
Page 1 of 3
Last Revised: 10 Oct 2014
Confidentiality Agreement Form
This confidentiality agreement verifies that you have read the associated policy, understand your role in
safeguarding confidential information and agree to adhere to the associated restrictions. Violations of this
agreement are governed by the Policy Prohibiting Illegal, Fraudulent, Dishonest, and Unethical Conduct and may
result in disciplinary action.
Confidentiality Agreement:
Consistent with all applicable policies and guidelines including, but not limited to, UD’s FERPA policy, I will
respect and safeguard the privacy of members of the
University of Dayton (UD) community and the confidential
nature of their information. Without limiting the general
nature of this commitment, I will not access or seek to gain
access to confidential information of any kind including, but not limited to, any past or
present employee, associate,
student, or alumni at UD, except in the course of fulfilling
my specific job responsibilities. _____ (applicant initial
here)
I acknowledge that the username/password I receive is itself confidential information. As such, I will not share the
username and password I receive with anyone, including peers and should not be asked to do so. If I have any
reason to believe the
confidentiality of my credentials has been violated, I will notify my supervisor or contract
manager immediately and
ensure the password is promptly changed. If I believe I have been asked to access or
release information lying outside
my defined job responsibilities, I will notify the University's IT Risk Management
Officer and request guidance. _____ (applicant initial here)
I recognize that my work for UD will bring me into close contact with confidential information. I further
acknowledge
that all data, software, records, information, and other assets held by UD or its third-party suppliers,
are proprietary. I agree
to uphold the confidentiality of the University of Dayton and the confidentiality UD has
established with third-party
suppliers. I have no right to use, reproduce, reverse engineer, publish, license,
distribute, disseminate, sell or
otherwise make available to any third party, anything proprietary that is made
available to me through my employment
or contractual engagement with UD except to perform my duties and
responsibilities in connection with my work for
UD. _____ (applicant initial here)
Applicant Signature Date
Print Full Name UD ID #
Position Building/Room Direct Phone
Department Company (if not the University of Dayton)
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signature
click to edit
UD Username:
UD ID Number:
Questions? Contact the UDit IT Risk Management Office at (937) 229-4387 or itriskmgmt@udayton.edu
Page 2 of 3
Last Revised: 10 Oct 2014
Similar to (identify person in your department with similar access):
BANNER
SELF-SERVICE BANNER (SSB) / FACULTY AND ADVISORS – View Current Student Information
BANNER INB - Used For Record Maintenance or More In-Depth Inquiry
BANNER DOCUMENT MANAGEMENT (BDM) – Access to Scanned Documents
BANNER RELATIONSHIP MANAGEMENT (BRM) – Access to Admissions Data
WORKFLOW – Business Process Automation
Specify Workflow:
Comments:
COGNOS – Finance, Student and HR reports
Comments:
DEGREEWORKS - Student Degree Progress
Comments:
VPN - Remote Access to Servers
Specify System/Services:
RAISER’S EDGE (Advancement Only)
Department / Comments: /
OTHER
UD Username:
UD ID Number:
Questions? Contact the UDit IT Risk Management Office at (937) 229-4387 or itriskmgmt@udayton.edu
Page 3 of 3
Last Revised: 10 Oct 2014
Student Worker (including Graduate Assistants)?
Yes
No
Expiration Date - If not provided, the account(s) requested will be reviewed and renewed periodically through the
Supervisor/Requesting Official and valid until rescinded by UDit. The terms and responsibilities set forth in this
agreement, however, survive the expiration of the access.
Supervisor/Requesting Official Signature Date
Print Full Name
Upon completion, please return this form to the UDit IT Risk Management Office, Miriam Hall 300, +2230.
When access is in place, the applicant will receive a follow-up email providing any relevant, system-specific
information.
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Confidentiality Agreement Form (University of Dayton)

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Completed 19 July 2020

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