Data Breach Complaint Form

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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 *

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First Name *

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Last Name *

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Phone Number *

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Relationship to Student *

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