Data Breach Complaint Form
Parents, eligible students (students who are at least 18 years of age or attending a
post secondary institution at any age), principals, teachers, and employees of an educational
agency may file a complaint about a possible breach or improper disclosure of student data
and/or protected teacher or principal data using this form. A privacy complaint may be made
using this online form or by mailing the form to the district’s Data Protection Officer at ISC Building, 140 Hulburt Rd, Fairport, NY, 14450.
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Email *
First Name *
Last Name *
Phone Number *
Relationship to Student *
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This form was created inside of Report Abuse