Fill - Free fillable Directions Request Type 1st time Authorization Reauthorization Department (California State University, Fullerton) PDF form

Directions

Complete and print this PDF form. Sign and return to Information Technology Office in PLS-260 or send scanned image

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Request Type 1st time Authorization Reauthorization Department Change

Security Group Name & Purpose

Security Group Owner

Name of Person who will add users to the

firewall Security group (must be an MPP):

Above Person's Department:

Above Person's Title:

Above Person's NT Alias:

Custodian of Records' Name:

I have read, understand and will comply with the CSUF statement of "Family Educational Rights and Privacy Act

(FERPA)" (see pages 2 and 3 of this form); and

CSUF President's Directive No. 13 (http://www.fullerton.edu/policies/presdir/dir13.htm).

Security Group Owner: Date:

Custodian of Records: Date:

Information Security Officer: Date:

Information Technology Use Only

Date Group Created: Date Group Deleted:

Re-delegated to: Security Group Name as Assigned:

Revised 7/07/2004

Signatures

The following information describes the Security Group Owner:

Requested Name for Security Group:

Purpose of the Security Group

Family Educational Rights

and Privacy Act of 1974

I. What is FERPA?

The Family Educational Rights and Privacy Act of 1974, also

known as "FERPA" or the "Buckley Amendment," protects the

privacy of student education records. The Act affords students

the right to (a) consent to disclosures of personally identifiable

information contained in their education records, except when

FERPA authorizes disclosure without consent; (b) inspect and

review their education records within 45 days of the university's

receipt of their request; (c) request amendment of an education

record thought to be inaccurate or misleading; and (d) file a

complaint with the U.S. Department of Education concerning

the university's alleged failure to comply with FERPA.

II. Who is protected under FERPA?

Students who are currently attending or who have previously

attended at Cal State Fullerton are protected by FERPA. FERPA

does not apply to records of applicants who are denied accept-

ance or, if accepted, do not attend Cal State Fullerton.

III. What is "personally identifiable

information?"

"Personally identifiable" information is data or information that

if known, would make a student's identity easily traceable. For

example, a student's name, address and social security number

are all personally identifiable information.

IV. What is an "education record?"

An "education record" is any record related directly to a student,

produced in any medium including but not limited to handwrit-

ing, print, tape, computer or film, and maintained by the univer-

sity or an agent of the university, except for:

a. Personal records of instructional, administrative and educa-

tional personnel, which are in the sole possession of the

maker and not accessible or revealed to any individual

except a temporary substitute;

b. Employment records of individuals whose employment is

not contingent on their student status, provided the records

are used only in relation to the individual's employment.

c. Records maintained by university police solely for law

enforcement purposes and revealed only to law enforcement

agencies of the same jurisdiction;

d. Records relating to treatment provided by a physician, psy-

chiatrist, psychologist or other recognized professional or

paraprofessional and disclosed only to individuals providing

treatment, and

e. Records that contain information about a student after that

student no longer attends the university and do not relate to

that individual as a student.

V. Who would generally be permitted access

to an education record without the student's

written consent from a student?

Cal State Fullerton will not disclose or permit access to any per-

sonally identifiable information from a student's education

record without that student's prior written consent except to:

a. School officials who have a legitimate educational interest in

the education record. Disclosure to a school official with a

legitimate educational interest does not constitute authoriza-

tion for that individual to share this information with others

not having a legitimate educational interest in the education

record. Any information received, after the purpose for its

review has been fulfilled, should be destroyed or returned to

the originating office for appropriate disposition;

b. Officials of other institutions, upon request, in which a stu-

dent seeks or intends to enroll;

c. FERPA-specified representatives of federal, state, and local

agencies and authorities associated with state and federally

supported education programs;

d. Persons or organizations responding to a student's request

for or receipt of financial aid, as necessary to determine the

eligibility, amount or conditions of the financial aid, or to

enforce the terms and conditions of the aid;

e. Institutions conducting studies to develop, validate, and

administer predictive tests, or to improve instruction;

f. Accrediting agencies carrying out their function;

g. Parents of a student who claim that student as a dependent

for income tax purposes. Prior to any such release, the uni-

versity will notify the student of the request and impending

release;

h. Comply with a judicial order or lawfully issued subpoena;

When relevant to the proceedings, to a court in the event

that a parent or student has initiated a legal action against

the university, or in the event that the university has initiat-

ed a legal action against a parent or student.

Protect the health and safety of students and other persons

in an emergency;

An alleged victim of a FERPA-specified crime of violence or

non-forcible sex offense, only as necessary to convey the

final outcome of any institutional disciplinary proceeding

against the alleged perpetrator of that crime with respect to

that crime;

Federal, state and local officials under FERPA-specified, lim-

ited circumstances.

VI. Who is a "school official" and what is a

"legitimate educational interest?"

Cal State Fullerton has defined "school official" to mean univer-

sity employees (including law enforcement and health person-

nel); agents of the University (such as an attorney or collection

agent); or individuals, including students, serving on official

committees or assisting a school official perform his/her tasks.

Cal State Fullerton has defined "legitimate educational interest"

to mean when a school official must review an education record

to fulfill their professional responsibility.

VII. What is directory information?

This personally identifiable information may be released general-

ly with a student's prior written consent. Cal State Fullerton des-

ignates the following as Directory information:

a. Student's name, date and place of birth, permanent and

local address, university-recognized e-mail address(es), tele-

phone number, class level, enrollment status, major, minor,

dates of attendance, degrees and awards received, previous

educational institutions attended, past and present participa-

tion in recognized activities, weight and height if an athletic

team member.

Students may choose to limit the release of their Directory infor-

mation in one of the following four ways:

a. Permit release of all Directory information. Unless restricted

by a student, Cal State Fullerton may release a student's

Directory information at any time to any requesting party,

including the military and for the development of universi-

ty-affiliated marketing programs.

b. Permit release of only "Verification" information. This sub-

category of Directory information consists of a student's

name, class level, enrollment status, major, minor, degrees

and awards received, dates of attendance and university-rec-

ognized e-mail address(es). The university will release this

information for classroom use; in response to requests,

including those from financial lenders, employers or insur-

ance companies for verification of degree and enrollment

information; and for inclusion in Commencement and hon-

ors materials. Students who release only "Verification" infor-

mation will be excluded from all university directories,

printed or electronic, that the university may produce or

publish.

c. Permit release of only "Class" information. This sub-category

of Directory information consists of a student's name, major,

minor, degree and awards received, and university-recog-

nized e-mail address(es). The university will release this

information only for classroom use and for inclusion in

Commencement and honors materials. Students who release

only "Class" information will be excluded from all university

directories that the university may produce or publish, and

the university will not respond to requests, including those

from financial lenders, employers or insurance companies,

for verification of degree and enrollment information.

d. Withhold the release of all Directory information.

Withholding the release of all Directory information means

that the student will be excluded from all university directo-

ries and publications that the university may produce or

publish, including Commencement and honors materials,

and the university will not verify degree, dates of attendance

or enrollment information without the prior written consent

of the student

Students may designate what directory information the universi-

ty may release, if any, either in person or on-line.

VIII. What documents can be removed from

an education record before the student views

the record?

A student may not inspect and review information in their edu-

cation record related to the following:

a. Financial information submitted by the student's parents;

b. Letters or statements of recommendation for which the stu-

dent has waived the right of access, or which were placed in

the student's file before January 1, 1975;

c. A record containing information about more than one stu-

dent, in which case the student will be permitted access

only to that part of the record which pertains to the inquir-

ing student; and

d. Any record that does not meet the definition of an "educa-

tion record."

This document provides only a summary of FERPA. For further infor-

mation regarding FERPA, how to inspect or amend an education

record, or how to file a complaint, please contact the Vice President

for Student Affairs Office in Langsdorf Hall 805.

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