Appendix B: Educational Technology Consent Form

Selkirk College

Educational Technology Consent Form

 As part of your learning experience at Selkirk College, you are being encouraged to use a third party learning resource called [name of educational technology] that runs on computer servers beyond the Selkirk Moodle online course platform. Therefore you will be given the following option to the tool: (describe learning alternative to third party learning resource).

The purpose of integrating this tool into your learning experience is to facilitate and improve academic writing skills and recognition of sources. The personal information collected by the third party when students are using this tool include Moodle ID number, email address, first and last name, and assignment submitted. The purposes for which that information is used by the third party are to compare the submission to previous submitted works at the institution and online resources to provide feedback on writing and citation practices.

This cloud-based learning tool is provided through a third party and is therefore not managed by or stored on Selkirk College computer servers. Information that you provide when using this tool and applications may be stored on computer servers located outside Canada. In particular, your information will be stored on servers in the [server location if known].  For more information about [name of educational technology] personal information privacy practices, please review their privacy policy and terms of use at [link to privacy policy of intended platform]

In British Columbia, public educational institutions are governed by the Freedom of Information and Protection of Privacy Act (“FIPPA”), which prohibits the storage of personal information outside of Canada in some circumstances.  For that reason, it is the College’s policy to make the use of these tools and applications voluntary.  If you wish to use [name of educational technology], please ensure that you sign and return this consent indicating that you consent to the collection, use, disclosure and storage of your personal information as described above. . Your consent will be stored by Selkirk College’s Privacy office.

If you have any questions about personal information or privacy issues with the use of [name of educational technology] you should contact your instructor.

Please indicate below by initialing whether you consent or do not consent.

__________ I CONSENT:  I have read the above notification and consent to the collection, use, disclosure and storage of my personal information as described above.

__________ I DO NOT CONSENT.  I do not consent to the collection, use and disclosure of my personal information using [name of educational technology].  I understand that it is my responsibility to contact my instructor to obtain or access alternate learning activities, processes or evaluations.

Name: ______________________________________________

Student Number: _____________________________________

Course: _____________________________________________

Signature: _______________________ Date: _____________________

Guardian (Student Under the Age of 18) _____________