Fillable STATE UNIVERSITY OF NEW YORK AT PLATTSBURGH Registrars (State University of New York at Plattsburgh)

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STATE UNIVERSITY OF NEW YORK AT PLATTSBURGH Registrars (State University of New York at Plattsburgh)

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_______________________________________________ ________________
________________________________________________ ________________
STATE UNIVERSITY OF NEW YORK AT PLATTSBURGH
Registrar’s Office
Student’s Name (Print): ___________________________ Start/End Dates: _______________________
STATEMENT OF UNDERSTANDING OF THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT (FERPA)
I understand by virtue of my employment or assignment by SUNY Plattsburgh as a teaching assistant,
graduate assistant, or in another capacity such as work-study or temp-service student that I may have
access to records which contain individually identifiable and confidential information about former or
currently enrolled students, the disclosure of which is prohibited by the Family Education Rights and
Privacy Act of 1974 (FERPA). I acknowledge that I have read SUNY Plattsburgh’s FERPA compliance
policy and that I fully understand that the intentional disclosure by me of protected information to any
unauthorized person(s) could subject me to criminal and civil penalties imposed by law. I further
acknowledge that such disclosure may also violate SUNY Plattsburgh’s FERPA compliance policy and
could constitute just cause for disciplinary action including termination of my employment or
assignment or a failing grade in the work-related course regardless of whether criminal or civil penalties
are imposed.
Student’s Signature Date
Indicate Approval in Email
Supervisor’s Signature Date
Record Retention: Supervisor retains this form three years after the end term entered above.
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STATE UNIVERSITY OF NEW YORK AT PLATTSBURGH Registrars (State University of New York at Plattsburgh)

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Completed 27 August 2020

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