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Vendor name:
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Directions to vendor: For each product, indicate whether (Yes or No) the product retains any of the following data fields for students.
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Product NameFirst initialFirst nameMiddle initialMiddle nameLast initial Last nameSchool name or codeSchool addressTeacher name or codeCourseGrade levelGenderDate of birthEthnicityRaceLanguageStudent addressStudent phone numberGuardian nameGuardian phone numberGuardian email addressStudent usernameStudent email addressStudent ID numberExternal passwordInternal passwordHealth informationPhotograph
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Directions to vendor: Below these directions, provide any clarifying notes about the responses above and clearly enumerate any additional fields maintained by the product.
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Directions to vendor: Submit this completed form alongside signed Student Data Privacy Requirements. A vendor-generated report that meets or exceeds the level of detail requested here may be submitted in lieu of this form, subject to acceptance by the Chief Information Offier
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