Forms Samples Letters Excuse by B_Gjas

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									Sample Permission-to-Excuse Letter
This sample letter is designed to help the principal decide whether or not to recommend to the superintendent that approval be given to excuse a student from writing an achievement test. Simple modifications to the letter could be made as the situation warrants. TO: Parent/Guardian RE: Name of Student In May and June of this year, students in grades 6 and 9 throughout the province will write provincial achievement tests in four subject areas: language arts, mathematics, science, and social studies. Students in the grade 9 Knowledge and Employability courses will write the Knowledge and Employability pilot tests in the four core subjects. Students in Grade 3 will write tests in language arts and mathematics. Results from these tests will provide Alberta Education, school administrators, teachers, parents, students, and the public with information about what students know and can do in relation to provincial standards at the end of grades 3, 6, and 9. These results can be used to improve learning opportunities for students. Test accommodations are available for students with learning disabilities or physical disabilities to allow these students to do their best. However, a superintendent should excuse a student from writing an achievement test if the student is not capable of responding to the test in its original or approved modified form, or if participation would be harmful to the student. The superintendent’s decision to excuse a student from completing one or more of the achievement tests is based on a recommendation from the principal, accompanied by supporting documentation. I am considering recommending to the superintendent that your child be excused from writing the provincial achievement test(s) in the following subject(s): Language Arts—Writing Mathematics Science Language Arts—Reading Social Studies Date

Please indicate your response below and return this letter. I agree with the proposal to excuse my child. I do not wish my child to be excused from writing. I would like an opportunity to discuss this recommendation.

Principal’s Signature

Parent/Guardian’s Signature

School
SAMPLES/FORMS/LETTERS 1

Date
November 2007

Sample Letter to Parents
This sample letter assumes that the classroom teacher has decided to use the achievement test in determining students’ final grades. Simple modifications to the letter could be made if this is not the decision.

To Parents of Students in Grades 3, 6, and 9: In May and June of this year, all Grade 3 students throughout the province will write provincial achievement tests in language arts and mathematics. Students in grades 6 and 9 will write tests in four subject areas: language arts, mathematics, science, and social studies. I will mark the tests before they are returned to Alberta Education so as to get an initial look at the performance of the students in my class. The tests cover what students have been learning this year fairly well, so I will be using your child’s score as ___ percent of the final grade. The final grade will represent your child’s overall performance in the full range of learning outcomes. In the fall, an Individual Student Profile showing your child’s achievement test results will be available at our school. The profile is prepared by Alberta Education when the marking of tests has been completed and final scores are tabulated. The profile will show your child’s performance on each test in relation to provincial standards. This information can be useful in planning your child’s instructional program for the coming year. You are invited to review your child’s results with his or her new teacher and to discuss how results will be reflected in the instructional program that is planned for the coming year. Reports that show how well our students did as a group in relation to provincial standards will also be available at our school in the fall. All parents and other members of our community will be invited to our school to discuss the results at that time. Please call our school if you have any questions.

SAMPLES/FORMS/LETTERS 2

November 2007

GRADE 3—May/June 2008 Provincial Achievement Tests

REQUEST FOR SPECIAL FORMAT MATERIALS

This request is to be completed only if you require special format materials. Once completed, forward to the Superintendent, for sign-off and return to Learner Assessment. SCHOOL: ______________________________ SCHOOL CODE: ___________

JURISDICTION: ______________________________

JURISDICTION CODE: ____________

For each subject, indicate the quantity of materials required.
Gr. 3 ELA Gr. 3 Math Timed Number Facts
Not available

Gr. 3 Math English

Gr. 3 Math French

Gr. 3 FLA

Gr. 3 Français

CD version Large-print version Braille version Other, Specify
(e.g., colour of paper)

Not available

Not available

Not available

Not available

Not available

Comments:

Note: If you have any questions about this form, contact the Special Cases/Accommodations Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at special.cases@gov.ab.ca. Date Telephone Number Date Principal’s Signature Superintendent’s Signature

Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at 10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889

SAMPLES/FORMS/LETTERS 3

August 2007

REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 6—May/June 2008 Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed, forward to the Superintendent, for sign-off and return to Learner Assessment. SCHOOL: ______________________________ SCHOOL CODE: ___________

JURISDICTION: ______________________________

JURISDICTION CODE: ____________

For each subject, indicate the quantity of materials required.
Gr. 6 ELA Gr. 6 Soc. St. English French Gr. 6 Math English French Gr. 6 Science English French Gr. 6 FLA Gr. 6 Français

CD version Large-print version Braille version Other, Specify
(e.g., colour of paper)
Not available Not available

Comments:

Note: If you have any questions about this form, contact the Special Cases/Accommodations Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at special.cases@gov.ab.ca.

Date

Telephone Number Date

Principal’s Signature Superintendent’s Signature

Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at 10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889

SAMPLES/FORMS/LETTERS 4

August 2007

REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 9 Semester—January 2008 Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed, forward to the Superintendent, for sign-off and return to Learner Assessment. SCHOOL: ______________________________ SCHOOL CODE: ___________

JURISDICTION: ______________________________

JURISDICTION CODE: ____________

For each subject, indicate the quantity of materials required.
Gr. 9 ELA Gr. 9 Soc. St. English French Gr. 9 Math English French Gr. 9 Science English French Gr. 9 FLA Gr. 9 Français

CD version Large-print version Braille version Other, Specify
(e.g., colour of paper)
Not available Not available

Comments:

Note: If you have any questions about this form, contact the Special Cases/Accommodations Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at special.cases@gov.ab.ca.

Date

Telephone Number Date

Principal’s Signature Superintendent’s Signature

Note: November 2, 2007, is the deadline for returning this form to Learner Assessment at 10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889

SAMPLES/FORMS/LETTERS 5

August 2007

REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 9—May/June 2008 Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed, forward to the Superintendent, for sign-off and return to Learner Assessment.
SCHOOL: JURISDICTION: ______________________________ ______________________________ SCHOOL CODE: JURISDICTION CODE: ___________ ____________

For each subject, indicate the quantity of materials required.
Gr. 9 ELA Gr. 9 Soc. St. English French Gr. 9 Math English French Gr. 9 Science English French Gr. 9 FLA Gr. 9 Français

CD version Large-print version Braille version Other, Specify
(e.g., colour of paper)
Not available Not available

Comments:

Note: If you have any questions about this form, contact the Special Cases/Accommodations Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at special.cases@gov.ab.ca. Date Telephone Number Date Principal’s Signature Superintendent’s Signature

Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at 10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889

SAMPLES/FORMS/LETTERS 6

August 2007

Achievement Testing Program 2007–2008 Shipment 1 Verification Form
Fax this form if you have problems with the shipment or have additional requirements.
School Code: School Name: School Contact Person: School Phone #: Testing Session: January (Grade 9 only) School Fax #: June

Please check the subject(s) and indicate problem or requirement Subject
ELA 3 Part A FLA 3 Partie A Fr 3 Partie A Timed Number Facts 3 ELA 6 Part A FLA 6 Partie A Fr 6 Partie A Mathematics 6 Part(ie) A ELA 9 Part A K&E ELA 9 Part A FLA 9 Partie A Fr 9 Partie A

Problem

Requirement

Fax this form to the Marking Centre at (780) 422-8323.

SAMPLES/FORMS/LETTERS 7

August 2007

Achievement Testing Program 2007–2008 Shipment 2 Verification Form
Fax this form if you have problems with the shipment or have additional requirements.
School Code: School Name: School Contact Person: School Phone #: Testing Session: January (Grade 9 only) School Fax #: June

Please check the subject(s) and indicate problem or requirement Subject ELA 3 Part B FLA 3 Partie B Fr 3 Partie B Mathematics 3 ELA 6 Part B FLA 6 Partie B Fr 6 Partie B Mathematics 6 Part B Science 6 Social 6 ELA 9 Part B K&E ELA 9 Part B FLA 9 Partie B Fr. 9 Partie B Mathematics 9 K&E Mathematics 9 Social 9 K&E Social 9 Science 9 K&E Science 9 Fax this form to the Marking Centre at (780) 422-8323. Problem Requirement

SAMPLES/FORMS/LETTERS 8

August 2007

Statement of Scribe, Reader and/or Interpreter and Principal—Grades 3/6/9 Achievement Tests
I,
Scribe/Reader/Interpreter (please print)

and
Principal (please print)

having read the procedures governing the use of , the achievement test(s) in

Scribe Reader Interpreter
Subject(s)

certify that to the best of our abilities

held at
School

during the
month

, 2008

testing period for
Student’s name (please print)

was administered and supervised in accordance with the specified procedures under the directives of the Minister of Education. was administered and supervised in accordance with the specified procedures under the directives of the Minister of Education, except as follows:

Dated this

day of

, 2008

Scribe’s/Reader’s/Interpreter’s Signature

Principal’s Signature

School Code

Please sign and return with the Principal’s Statement. If more than one individual is providing accommodation services to one student, please fill out separate forms.

SAMPLES/FORMS/LETTERS 9

August 2007

Example of the Back of a Written Response Booklet

Example of the Back of the Test Booklet Please place the label on the back of the Readings Booklet

GRADE 3 ENGLISH LANGUAGE ARTS Part B

To be completed by/for ALL students.
Last Name (please print) First Name

C Name
Apply Label With Student’s Name F

To be completed ONLY for students without labels.
Alberta Student Number School Name Birth Date (Year/Month/Day) School Code Sex: M

ACCOMMODATIONS USED (mark all applicable) 1 2 3 4 5 6 7 8 9 10

COMPLETED THE COURSE IN A YEAR OTHER THAN THE YEAR OF TESTING

HOME EDUCATED FOR THIS SUBJECT

PAT0300001M.02

SAMPLES/FORMS/LETTERS 10

August 2007

Sample of the Back of the Timed Number Facts

The chart below outlines the number and description of the labels that will be sent for each achievement test administration.
Grade/Subject Grade 3 ELA, FLA and Français Part(ie) A Tests ELA—Part B Timed Number Facts Multiple Choice Grade 6 ELA, FLA and Français Part(ie) A Tests Mathematics Part(ie) A All Machine Scored Tests Grade 9 ELA, FLA & Français Part(ie) A Tests and the K&E Part A Pilot Test All Machine Scored Tests and the K&E Pilot Tests Number of Labels 2 per booklet 1 per booklet 1 per booklet 1 per booklet 2 per booklet 1 per booklet 1 per answer sheet 1 per booklet 1 per answer sheet 2 per booklet Description One with student name One without student name With student name With student name With student name One with student name One without student name With student name With student name With student name With student name One with student name One without student name With student name With student name

1 per booklet 1 per answer sheet

SAMPLES/FORMS/LETTERS 11

November 2007

June 2008 Achievement Tests LIST OF STUDENTS #1 Grade 3
The New Century School (403) 321-4321 Alberta School Division No. 99
Tests Completed for Unregis. Students Absent(A) Excused(E) Tests NOT Completed by Students Transferred(T) TOTAL

SAMPLES/FORMS/LETTERS + + + + + + + + + + +

School: 9999 Authority: 0000

Regis. Students

5
+ + + +

4 4 4 4 4 0 1 1 1 0 1 0 1

0

1

+ + + + +

1 1 1 1 1

= = = = =

11 11 11 11 11

5

5

12

ELA 3 Part A FLA 3 Part A Fr 3 Part A Math 3 Part A Math 3F Part A

4

5

“+”signs are included to assist with accurate completion of this sheet.

August 2007

Principals MUST return this signed List of Students even if NO students took part in the testing.

June 2008 Achievement Tests LIST OF STUDENTS #1 Grade 3
The New Century School (403) 321-4321 Alberta School Division No. 99
This student received instruction in French and wrote in French.

SAMPLES/FORMS/LETTERS
Student Name Surname, Given Names Sex Birth Date ELA Part A FLA 3 Partie A Fr 3 Partie A Math 3 Part A Math 3F Part A A This student transferred. T E T E T E T E F M M M F M F M 1997-12-19 1998-01-09 1997-11-10 1996-11-02 1997-06-22 1997-02-09 1997-04-29 1997-09-04 T E The Superintendent excused (E) this student from writing the Achievement Tests.
F M F M 1997-05-10 1997-01-19 1998-07-17 1997-02-14

School: 9999 Authority: 0000

Alberta Student Number

This student transferred.

13
These four students are unregistered and have been added to the List of Students.

1056-1387-1 9801-0002-3 9711-6742-3 1002-6534-4 1007-0122-3 9702-3659-1 9704-7432-1 1007-0931-1

Appleyard, Mary Browning, Peter Copeland, Robert Dickens, Aaron Emerson, Charlene Frost, Robert Wayne Highliner, Deanne Nighthood, Chris

This student is a “Home Education”

9702-5713-8

RAINE, SUSAN

9607-8901-7

SMITH JEFFREY

1001-7432-1

PERCY, LINDA (HOME ED)

1011-6941-5

NELSON, RANDY (OUT OF GRADE)

This student is not in Grade 3.

August 2007

June 2007 Provincial Achievement Tests Principal's Statement #1 Grade 3
The New Century School Alberta School Division No.99

(English Language Arts 3 Part A & B, French Language Arts 3 Partie A & B, Français Language Arts 3 Partie A & B, Mathematics 3 Part A, Mathématiques 3 Part A)

SAMPLES/FORMS/LETTERS

School: 9999 Authority: 0000

The duties and responsibilities of the principal when administering the June 2008 Achievement Tests are described in the 2007-2008 School Year Achievement Testing Program General Information Bulletin. The Principal’s Statement serves to certify that these duties and responsibilities have been fulfilled. Please check ( ) each box (where appropriate) to indicate that, as principal, you have followed these procedures.

Before Administration

1. Test cartons were resealed and locked in a secure storage facility after verification of the test shipment.

2. I discussed with supervising teachers key aspects of supervising Achievement Tests as described in the 2007-2008 School

Year Achievement Testing Program General Information Bulletin.

14

3. Materials allowed for Part(ie) A of English Language Arts 3, 6, and 9 and Français 3, 6 and 9 and French Language Arts 3, 6

and 9 tests were inspected before use.

4. All calculators were cleared to ensure that no information was stored in programmable or parametric memory.

5. I am satisfied that the level of supervision during the writing of the achievement tests was acceptable and allowed for a fair

and valid evaluation of students’ achievement.

6. I am satisfied that my school complied with all achievement test writing rules and procedures for administering achievement

tests on the school’s computers. Note: Please put NA in box #6 if your school did not use this provision.

7. Each test area was free from internal and external distractions.

8a. The tests were administered without incident or irregularities, and without violation of test rules.

OR

August 2007

8b. The following irregularities (including violation of the test rules) occurred during the administration of the tests: ____________________________________________________________________________________________ ____________________________________________________________________________________________

Following Administration

9. The test materials were prepared for return to the Learner Assessment according to the 2007-2008 School Year

Achievement Testing Program General Information Bulletin.

SAMPLES/FORMS/LETTERS School Phone # ____________________________ Summer Contact (please print)_________________________________

For return of Shipment 1:

Language Arts: Part(ie) A

Grade 3 Mathematics: Timed Number Facts

Grade 6 Mathematics Part A: Operations and Number Sense

For return of Shipment 2:

All other tests

15

Declaration: I hereby certify that in my capacity as principal I carried out my duties and responsibilities as required by the 2007-2008 School Year Achievement Testing Program General Information Bulletin. I attest that no secured achievement test materials were copied in whole or in part in any manner or have been retained at the school, and that all Teacher Perusal Copies are enclosed with the Principal’s Statement.

Date_________________ Principal's Name (please print)_____________________ Principal's Signature__________________________

School________________________________________________________________________________________

School Code ______________________

Summer Phone Number___________________________

November 2007

Note: The return of a completed Principal’s Statement, with each List of Students (LOS), even if no student wrote the examination, is a mandatory requirement of Alberta Education


								
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