FWISD Non-disclosure Agreement

Fort Worth Independent School District
Confidentiality Agreement

In rendering performance under this agreement, _________________________
will ensure compliance with all applicable statutory requirements relating to the
confidentiality of student education records set forth in state law and the Family
Educational Rights and Privacy Act (FERPA). This includes encrypting individual
student identifiers, keeping data safeguarded, not sharing or reporting individual data
to third parties for research or other purposes, and using the data only for agreed upon
research and program development purposes. _________________________ will
have a system in effect to protect education records that are maintained or provided to it
in connection with this agreement. _________________________ will not
transfer or disclose any identifiable student education records to another person or
entity without the express written consent of someone authorized by law to act on behalf
of the student. _________________________ understands and agrees that no
confidential information regarding any students will be disclosed in any document
intended for public disclosure. At the end of the term of this contract, all student
education records must be destroyed or returned to the Fort Worth Independent School
District.
_________________________
Signature
_________________________
Printed Name
_________________________
Date

FWISD Committee for External Research
Review
Revised August 2015

Please mail, fax, or email a copy of the
signed document to:
Committee for External Research Review
Leadership, Learning, and Student Support
Services
100 N. University Drive, Suite SW 212
Fort Worth, Texas 76107
Fax: 817-814-1855
Email: askeval@fwisd.org