1-PII Questionnaire.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
USBE - Utah Adult Education Numeracy Project
Solicitation number
USBE-SD27021-PS
Issued by
Utah

About this file

This is a PII (Personally Identifiable Information) Questionnaire filed by the Utah State Board of Education in connection with the USBE - Utah Adult Education Numeracy Project solicitation. The questionnaire documents the categories of data elements that will be collected, used, stored, or processed by the system, including student PII such as assessment scores, communications data, conduct information, demographics, enrollment details, special indicators, contact information, performance data, program membership, survey responses, and student work products. Additionally, the form captures educator PII including name, gender, date of birth, identification number, school and class assignments, salary information, and license information, as well as parent/guardian contact information and any PCI credit card protected data that may be utilized by the application.

This questionnaire serves as a critical disclosure document for the adult education numeracy project, ensuring compliance with data privacy and security requirements by explicitly identifying all personal information categories that will be handled by the system. The comprehensive nature of the data inventory—spanning student, educator, and parent information across multiple functional areas including assessment, enrollment, communications, and behavioral tracking—indicates that the successful vendor will need to implement robust data protection protocols and demonstrate compliance with applicable privacy regulations and Utah administrative requirements governing the use and storage of sensitive educational data.

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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 .