MICHIGAN JEWISH INSTITUTE
Policy and Procedure Manual
Functional Area: RECORDS MANAGEMENT
Title: Confidentiality of Student Records
Effective Date: March 2001
Policy No. RM 1110
Page No.
GENERAL PURPOSE:
This policy is intended to provide a policy, process and procedure that will insure the confidentiality of all student records.
The Michigan Jewish Institute recognizes the importance of ensuring the confidentiality of student records and adheres to the tenets of the Federal Family Educational Rights
Privacy Act of 1974 and as amended from time to time. The following three principles embody the fundamentals of the student’s right to privacy:
1. Students shall have access to information being maintained about them by the
Institute;
2. A student may authorize in writing the release of any information maintained about him/her to any person s/he chooses;
3. The Institute will release no information to any person without the written consent of the student about whom the information is being maintained. Such written consent must be signed and dated by the student and must specify the information to be released, the reasons for the release, and the name or names of the person or persons to whom the information is to be released.
Definitions . “Confidential Student Information” is all student information in whatever form, tangible or intangible, pertaining in any manner to student education, financing and any other educative or business activity conducted on behalf of the student by MJI, or any of its affiliates, or its faculty, administrative staff, consultants, or business associates, or which is produced by any of them in the course of their employment or consulting relationship or otherwise produced or acquired by or on behalf of students.
All Confidential Student Information not generally known outside of the MJI organization, and all such other private information so known through proper or
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Revised December 2003
Printed February 10, 2013

Functional Area: RECORDS MANAGEMENT
Title: Confidentiality of Student Records
Effective Date: March 2001
MICHIGAN JEWISH INSTITUTE
Policy and Procedure Manual
Policy No. RM 1110
Page No.
(3) All income and other financial aid information supplied by the student or otherwise obtained by MJI;
(4) Student Program Planning forms and decisions;
(5) All semester registration forms and class attendance logs;
(6) Student exam and paper scores and all grade records;
(7) All letters from and to MJI regarding the student; and,
(8) all other information of which the unauthorized disclosure could be detrimental to the interests of the student, whether or not MJI or the student identifies such information as Confidential Information.
POLICY:
It is the policy of MJI that:
(1) All student information in the student record and financial records is
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By example and without limiting the foregoing definition, Confidential Student
Information shall include, but not be limited to:
(1) Application forms, including all supplemental information provided, including but not limited to: MJI application form; cover letters; all transcripts; letters of recommendation; test scores; etc.;
(2) All financial information including tuition and other payments and any arrearages;

MICHIGAN JEWISH INSTITUTE
Policy and Procedure Manual
Functional Area: RECORDS MANAGEMENT
Title: Confidentiality of Student Records
Effective Date: March 2001
Policy No. RM 1110
Page No.
confidential and should only be released in accordance with applicable legal and/or regulatory requirements;
(2) All MJI employees are orientated to confidentiality policies upon onset of employment at MJI;
(3) Information about students maintained by MJI shall be released only to
MJI employees when the information requested is necessary to perform
Institute duties, when required by law or other authorized regulatory necessity (and accompanied by an appropriate “Record of Disclosure” form (see end of this policy for generic form, if needed), or when the student has given written permission for release of the information;
(4) Access to computerized student information is controlled through passwords and differing levels of access based on a need to know;
(5) Users with individual codes must log off their computers whenever leaving a terminal; and,
(6) All hard copy student and financial records will be kept in fire resistant and secure drawers and locked daily.
PROCESS:
All employees sign an acknowledgement of this policy, which includes the following language:
I will not, directly or indirectly, use, make available, sell, disclose or otherwise communicate to any third party, other than in my assigned duties and for the benefit of the student or MJI, any students’ Confidential
Information, either during or after my employment with MJI. Furthermore, I acknowledge that I am aware that the unauthorized disclosure of
Students’ Confidential Information may be highly prejudicial to their interests, an invasion of privacy, an improper disclosure of otherwise secret information and completely against MJI policy.
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Revised December 2003
Printed February 10, 2013

MICHIGAN JEWISH INSTITUTE
Policy and Procedure Manual
Functional Area: RECORDS MANAGEMENT
Title: Confidentiality of Student Records
Effective Date: March 2001
Policy No. RM 1110
Page No.
I shall maintain at my workstation and/or any other place under my control only such Confidential Information as I have a current “need to know.” I shall return to the appropriate person or location or otherwise properly dispose of Confidential Information once that need to know no longer exists. I shall not make copies of or otherwise reproduce Confidential
Information unless there is a legitimate business need for such reproduction.
Upon request or when my employment with MJI terminates, I will immediately deliver to MJI all copies of any and all materials and information received from, created for, or belonging to MJI including, but not limited to, those which relate to or contain Student Confidential
Information.
______________________ ______________
Employee signature Date
The signed form will be collected from all MJI employees with access to confidential student information and made part of their employee files.
Whenever a request for student information is received by MJI, the responding MJI employee will obtain a proper and signed Release of Information form from the subject student. No information will otherwise be released until the release form is in MJI’s possession and made a permanent part of the Student Record.
AUTHORIZATIONS : (at least one signature is necessary to enact this policy/procedure)
_______________________________ ______________________________
President For Academic Administration
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EMPLOYEE ACKNOWLEDGEMENT OF RECEIPT: MJI CONFIDENTIALITY OF
STUDENT RECORDS POLICY
I acknowledge that I have received a copy of the MJI Confidentiality of Student Records
Policy Statement. Furthermore:
I will not, directly or indirectly, use, make available, sell, disclose or otherwise communicate to any third party, other than in my assigned duties and for the benefit of the student or MJI, any of the students’
Confidential Information, either during or after my employment with MJI.
Furthermore, I acknowledge that I am aware that the unauthorized disclosure of Students’ Confidential Information may be highly prejudicial to their interests, an invasion of privacy, an improper disclosure of otherwise secret information and completely against MJI policy.
I shall maintain at my workstation and/or any other place under my control only such Confidential Information as I have a current “need to know.” I shall return to the appropriate person or location or otherwise properly dispose of Confidential Information once that need to know no longer exists. I shall not make copies of or otherwise reproduce Confidential
Information unless there is a legitimate business need for such reproduction.
Upon request or when my employment with MJI terminates, I will immediately deliver to MJI all copies of any and all materials and information received from, created for, or belonging to MJI including, but not limited to, those which relate to or contain Student Confidential
Information.
______________________ ______________
Employee signature Date
Revised December 2003
Printed February 10, 2013

RELEASE OF INFORMATION
By completing and signing this form, a Michigan Jewish Institute student permits MJI to exchange information, upon request, with the parent, counselor or other interested party named below by the student. Unless specifically restricted, this would include but not be limited to information about enrollment, financial aid awards, attendance and grades.
I _____________________________ hereby grant the Michigan Jewish Institute and
STUDENT’S NAME (PLEASE PRINT) its employees permission to release (check one) :
 ANY information or  ONLY the following information: (if filled in) __________________________________________ it has about me to
_____________________________________________________________________________________________________________.
PRINT NAME OF PARENT(S), COUNSELOR OR OTHER INTERESTED PARTY THIS RELEASE IS FOR
This release is to remain in force from today’s date (as indicated next to my signature) until _______________ or until I file a revocation of information release, whichever date comes first.
I also acknowledge that I understand that once MJI releases information to a third party, that third party may in turn disclose it to someone else and that third party may not in any way be restricted by MJI’s policies and procedures regarding disclosure of confidential information.
A photocopy or facsimile of this Release of Information form shall be considered as effective and valid as the original.
All the above has been explained to me and all my questions regarding this release have been answered to my complete satisfaction.
_________________________________
Signature
Print Name
_________________________________
_________________
Date
__________________
Social Security Number
Revised December 2003
Printed February 10, 2013

RECORD OF DISCLOSURE
This form is a Record of Disclosure as required by the Family Educational Rights and
Privacy Act (FERPA) of 1974. In compliance with FERPA and under Section _____ of the U.S. Department of Education regulations, I/we the undersigned have had access to this student’s academic record.
The purpose of this access is described as (please provide a detailed explanation of why you made access to this student’s record here. You may attach additional information as needed.):
I/we the undersigned will not release any of this student’s information to anyone else unless permissible under FERPA or otherwise required by law or regulation.
_________________________________
Signature
_________________________________
_________________
Date
Print Name
__________________
SSN or other ID number
_________________________________________________________________
Authorizing Authority
THIS RECORD OF DISCLOSURE IS TO BE COMPLETED
AND
MADE PART OF THIS STUDENT’S PERMANENT RECORD
Revised December 2003
Printed February 10, 2013