Employee Name: ___________________________ ___________________________ _________
Last Name First Name Middle Initial
Social Security Number: _____________________________
Job Title: Department: _________________________
Please read, sign, and date the bottom of this form and return to the Human
Resources Office. This form must be returned before a contract and/or paycheck is
FERPA (Confidentiality Statement)
Along with the right to access the transcripts and records of students at Gadsden State
Community College comes the responsibility to maintain the rights of students,
particularly as outlined in the Family Educational Rights and Privacy Act (FERPA). The
College Catalog, Semester Schedule Bulletins, and Faculty/Staff Handbook state the
policy regarding student records at Gadsden State Community College. Student records
are open to members of the faculty and staff who have a legitimate need to know their
contents; however, you do have a responsibility to maintain confidentiality. Under the
terms of FERPA, Gadsden State Community College has established the following items
as directory information: student’s name, address, telephone number, date of birth, and
major fields of study, as well as information about students’ participation in officially
recognized activities and sports, the weight and height of members of athletic teams, the
dates of attendance by students, degrees and awards received, and the most recent
previous educational agency or institution attended by a student. No other information
may be released without written consent of the student. Grades, Social Security
Numbers, Race, Ethnicity, and Student Schedules must not be released to anyone other
than the student under discussion and never over the telephone or by e-mail.
All paperwork containing personally identifiable information and is not part of the
students’ official records, must be disposed of in a safe and timely manner. It is
recommended that all personally identifiable information not part of the educational
record be shredded. Please refer questions to the Office of the Registrar (256) 549-8263.
I have read the above and agree to maintain the confidentiality of student records. I
understand that failure to maintain such confidentiality may be a violation of State Board
of Education policy and Federal Law.
________________________________________________________ ___________________________
Employee Signature Date
Gadsden State Community College
Student Records Access Form
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