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Unauthorized Release/Data Security Incident Reporting Form

Parents, eligible students (students who are at least 18 years of age), principals, teachers, and employees of an educational agency may file a complaint about a possible data security incident or improper disclosure of student data and/or protected teacher or principal data. A privacy complaint may be made using this online form or by mailing the form to the district's Data Protection Officer at North Rose-Wolcott Central Schools. PLEASE DO NOT INCLUDE ANY PERSONALLY IDENTIFIABLE STUDENT INFORMATION ON THIS FORM.

Education Agencies are required by Ed Law 2D, Part 121.4 to report their findings of this investigation within 60 calendar days of the initial report.

Please fill out the following form to submit a privacy complaint.

You may also mail a complaint to:
Data Protection Officer
11631 Salter-Colvin Road
Wolcott, NY 14590

Role (select at least one)
Location of Incident
Must contain a date in M/D/YYYY format
Please do not use any personally identifiable information!