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confidentiality contract

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					         Gallaudet University




                                            Confidentiality Contract
Student Academic Center, Room 1221


As an employee at TIP you need to be aware that much of the information received in
our office is confidential and CANNOT be shared outside this office. There are
established policies and procedures for the accumulation and custody of confidential
information at Gallaudet. All student records and other information received and stored
at TIP should never be improperly used or released to an unauthorized person. If you
have a question regarding whether or not to release information to an individual, please
ask your supervisor.

By signing this agreement, you agree to uphold TIP’s Confidentiality Policy. This
means you will not share student information with ANYONE.

Examples of confidential information are:
     • Student Grade Reports
     • Student Transcripts
     • Student Tutoring Files
     • Complaints from students, faculty and staff
     • Tutorial/Advising sessions
     • Mail
     • Attendance at TIP
     • Personal information
     • Disabilities
     • Any information from University or TIP databases.
     • Any other office-related issues

I understand that I may have access to confidential information and that it is my
responsibility to maintain the integrity of this information and to keep it private. I further
understand that disclosure of confidential information will result in disciplinary action (i.e.
termination of employment).

                                _________________________________________________
                                                        PRINT NAME of TIP Employee

                                _________________________________________________
                                             Signature of TIP Employee and Today’s Date

                                _________________________________________________
                                            Signature of TIP Supervisor and Today’s Date