Confidentiality Statement

Printable Version [PDF]

As an employee/student employee/graduate assistant of Shippensburg University of Pennsylvania I understand that I may have access to confidential, personal data and/or records of University employees, students, customers and other related constituents. I agree that I will access, use, discuss, release and/or divulge only the data that is needed to perform my job. I understand that I am prohibited from accessing, using, discussing, releasing and/or divulging this data unless doing so is a requirement of my job.

I further understand that unauthorized disclosure of confidential information and records applies to all information on the University computing/networking systems, all printed information, as well as formal and informal verbal conversations.

I understand that any release of this information will be done only through authorized protocols. Breaches in confidentiality of such data may result in disciplinary action up to and including separation from employment and in the case of student employees and graduate assistants, possible University judicial action. A violation of this agreement also may result in legal action if it is determined that any local, state, or federal laws have been violated.

I have had the opportunity to discuss this responsibility with a representative of the University, and by my signature below, I am certifying that I have read, understand, and agree to abide by the provisions of this statement.

Name ___________________________________

Signature ________________________________ Date ____________________

I have discussed the confidentiality statement with the above individual and he/she has acknowledged their understanding and acceptance of the above.

Name __________________________________ Title _____________________

Signature ________________________________ Date ____________________

Resources for:
Related Links