FERPA ACKNOWLEDGEMENT

I understand that by the virtue of my affiliation with Tidewater Community College, I may have access to records which contain individually identifiable information, the disclosure of which is prohibited by the Family Educational Rights and Privacy Act of 1974.

I acknowledge that I fully understand that the intentional disclosure by me of this information to any unauthorized person could subject me to criminal and civil penalties imposed by law.

I further acknowledge that such willful or unauthorized disclosure also violates Tidewater Community College?s policy and could constitute just cause for disciplinary action including termination of my employment regardless of whether criminal or civil penalties are imposed.

By submission of the following information, I indicate that I have participated in the College's FERPA training. I also acknowledge that if I have questions or concerns regarding FERPA, the College Registrar serves as the College's contact person.

Name*

First

Last

SISID*

Campus*

Department*

Phone*

TCC email address*

By checking this box, you affirm your acknowledgement of the responsibilities of FERPA and the importance of protecting students' and employees' personal information.*

I understand, and hereby digitally sign this form.

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