The Department of Digital Learning
2015-2016
2015-2016 DIGITAL CITIZENSHIP Verification Form
The Federal Communications Commission (FCC) outlines Children's Internet Protection Act
(CIPA) requirements. Under this law, Fort Bend Independent School District’s (FBISD) Digital
Citizenship Document requires all FBISD Students to view a Digital Citizenship video.
Once all students on your campus have viewed their grade‐level’s video (as verified by campus
administrators), return form to the attention of Lisa Rivarde, Administrative Assistant to the
Director of Digital Learning.
Submit options:
 Via inter-district mail
 Scanning as an electronic mail attachment to: lisa.rivarde@fortbendisd.com
 Electronic Fax, 281-327-1265
Note: Please contact Lisa Rivarde for any questions pertaining to form submissions and
confirmations at 281-634-1265, direct line.
If you are sending your form via electronic mail, please use the following subject line:
“YOUR CAMPUS’ NAME Digital Citizenship Verification Form 2015-2016”
Form must be received by: October 16, 2015
By signing below, you are verifying that all students on your campus viewed the
mandatory Digital Citizenship video for their grade level.
Campus: _________________________________
Date: ___________________________________
Principal’s Signature (or Administrative Designee):
_______________________________________
Fort Bend Independent School District Administrative Annex
3119 Sweetwater Blvd Sugar Land, TX 77479