Common Core & Year-End Standardized Testing Opt-Out Form printable pdf download

Common Core & Year-End Standardized Testing Opt-Out Form

Common Core & Year-End Standardized Testing

Opt-Out Form

As the parent, or legal guardian, of ___________________________ (child’s full name), I

realize I have the fundamental and legal right to direct the upbringing and education of my

child. I hereby respectfully and formally state that:

1) I do not permit the school to administer to my child any of the following computerized tests

over any subjects:

 Common Core formative tests

 Kansas College and Career Ready formative tests

 Any other standardized formative tests

 Common Core summative standardized year-end tests

 Kansas College and Career Ready summative standardized year-end tests

 Any other standardized summative year-end tests

2) Except for standard enrollment information necessary to fulfill financial accounting

requirements, NO personal data about my child or our family shall be sent to any State or

Federal agency, contractor, or vendor outside of this school district. All State and Federal laws

to protect the privacy of my child and our family shall be enforced by the administrators,

teachers and employees of this school district.

3) Any school district employee, elected official, contractor, or vendor who fails to abide by this

notice without my written consent shall be held accountable to the fullest extent of Federal and

State laws.

Please honor my request and keep this signed, written notice on file in my child’s cumulative

folder.

Child’s name _____________________________________ Grade Level _________

Parent’s name ____________________________________

Parent’s signature _________________________________ Date _______________

Parent’s signature __________________________________Date_______________

School Name _____________________________________

School District ____________________________________ School Year _________

Received by_______________________________________ Date Received________

Common Core & Year-End Standardized Testing Opt-Out Form