1-PII Questionnaire.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
USBE - Avoid Deny Defend training for Grades K-12
Solicitation number
USBE-SD26393-PS
Issued by
Utah

About this file

This is a Personal Identifiable Information (PII) Questionnaire submitted to the Utah State Board of Education (USBE) in connection with a Request for Statement of Qualifications (RFSQ) for emergency preparedness training. The document serves as a data inventory tool requiring vendors to identify which student, educator, parent, and payment card data elements will be collected, used, or stored by their proposed system or application. The questionnaire covers multiple categories of PII including student assessment data, communications, conduct records, demographics, enrollment information, special indicators, contact information, performance metrics, program memberships, survey responses, and student work products. For educators, the form addresses name, gender, date of birth, identification numbers, school and class assignments, salary, and license information. Parent/guardian contact information and credit card data are also included in the inventory matrix.

The USBE issued this RFSQ to obtain qualified vendors for delivering developmentally appropriate Avoid, Deny, Defend emergency preparedness training protocols for K-12 school leaders and personnel across Utah. The maximum contract value is $175,000, with the current all-inclusive project budget set at $170,000. This is a small purchase professional services procurement conducted under Utah Administrative Rule R277-122-6, likely resulting in a single contract award to a responsive and responsible offeror. The PII questionnaire functions as a compliance and risk assessment document, requiring vendors to transparently disclose their data handling practices and the specific categories of sensitive information their training systems will access or manage during implementation.

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Text version

Sheet1

Instructions: Please check which data elements will be used by system and return to USBE
Data TypeData ElementCheck if used by system or provide additional information
Student PIIAssessmentStandardized test score
Observation data
Other assessment data (Please specify)
CommunicationsOnline communications that are captured (emails, blog entries)
ConductConduct or behavioral data
DemographicsDate of Birth
Place of Birth
Gender
Ethnicity or race
Language information (native, preferred, spoken, etc)
Other demographic information (Please specify)
EnrollmentStudent attendance data
Student school enrollment
Student grade level
Assigned educator
Specific curriculum programs
Year of graduation
Other enrollment information (please specify)
Special IndicatorEnglish language learner information
Low income status
Medical alerts /health data
Student disability information
Specialized education services (IEP or 504)
Living situations (homeless/foster care)
Other indicator information-Please specify:
Student Contact InformationAddress
Email
Phone
Name
Student ID Number
Student PerformanceProgram/application performance (typing program-student types 60 wpm, reading program-student reads below grade level)
Student Program MembershipAcademic or extracurricular activities a student may belong to or participate in
Student Survey ResponsesStudent responses to surveys or questionnaires
Student workStudent generated content; writing, pictures etc.
Other student work data -Please specify:
OtherPlease list each additional data element used, stored or collected by your application
Educator PIIEducator informationName
Gender
Date of Birth
Identification number
School assignment
Class assignment
Salary information
License information
Parent PIIParent/Guardian Contact InformationAddress
Email
Phone
Name
Other information (Please specify)
PCICredit CardPCI protected data
Other information (Please specify)

File details come from the government source that posted it. Updated .