1-PII Questionnaire.xlsx

XLSX spreadsheet 15 KB Posted

Attached to
Continuous Improvement Expert for Springboard School Grant - The Jean Massieu School of the Deaf
Solicitation number
USBE-CC26455-PS
Issued by
Utah

About this file

This is a Personally Identifiable Information (PII) Questionnaire submitted to the Utah State Board of Education (USBE) in connection with a Request for Statement of Qualifications for a Continuous Improvement Expert position at The Jean Massieu School of the Deaf. The questionnaire identifies data elements that a system will use, store, or collect across multiple categories including student PII, educator PII, parent PII, and payment card information. Student data elements encompassed include assessment scores, communications, conduct data, demographics, enrollment information, special indicators, contact information, performance metrics, program membership, survey responses, and student-generated work. Educator data includes name, gender, date of birth, identification numbers, school and class assignments, salary information, and license information. Parent or guardian data covers contact information including address, email, phone, and name.

The questionnaire serves as a compliance and transparency tool for the USBE to understand what personal information will be collected and utilized by the system supporting the Continuous Improvement Expert contract. No pricing, award dates, contract terms, or specific performance metrics are detailed in this questionnaire document. The form functions as a preliminary data governance assessment rather than a procurement instrument with specific deliverables, timelines, or financial terms. Respondents are instructed to check which data elements will be used by the system and provide additional information where applicable, enabling USBE to maintain oversight of PII handling in connection with the school improvement initiative for the designated springboard school.

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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 .