Employee Data Release Form printable pdf download

EMPLOYEE DATA RELEASE FORM

This form is to be used whenever an agency/vendor/organization is requesting access to employee information. Directory

information includes employee name, home address and telephone number. There will be a charge for each standard report based

upon the type (non-profit or profit), the length and type of report requested as well as programming type involved. All requests

from outside vendors/organizations must be prepaid. Please make your check payable to Birdville ISD for the minimum payment

and mail the payment and completed form to Birdville Independent School District, Attn: Business Office, 6125 E. Belknap,

Haltom City, TX 76117.

Name of Person Requesting Report: __________________________________________ Telephone Number: _______________

Name of Company/Business:

____________________________________ Date Requested: _____________________________

Type of Report Request:

Listing

Electronic (Email)

Electronic (CD/Floppy)

(Circle desired type of request)

Number of Copies Requested:

__________________

Exact Description of Report Requested (please include format and all fields you wish to have on the report:

____________________________________________________________________________________________________________

Sort Option:

Alpha

Alpha by Campus

Alpha by Zip

Alpha by Class

Other:___________

BISD use only:

BISD Authorized by: ___________________________ Date: _________________

(to be signed by Business Office Personnel)

File Name/Server: ___________________ Completed by: ____________________ Date: ____________________

Payment Schedule for Data Release

These payments are the minimum charge for data. These fees could be more based on programming time and data volume. All charges include

1 hour of programming time plus materials needed for the minimum release.

Listings

BISD Organizations / PTA

No Charge

Non-Profit Organizations

$.07 per page (minimum charge of $10.00)

For-Profit Organizations

$.10 per page (minimum charge of $15.00)

Electronic (Email) Requestors e-mail: ____________________________________________________________

All Requests

Minimum charge

$26.00 – This include 1 hour of programming time

Electronic (CD/Floppy)

All Requests

Minimum charge $27.00 – This includes 1 hour of programming time plus the cost of media (CD-

Rom or Floppy)

Note: Once your request has been generated, if the charge is more than the minimal amount, you will be invoiced for the remaining

balance. Outstanding charges must be paid in full before data will be released. Minimal payment is required before request will

be processed and is non-refundable.

Employee Data Release Form

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