Fillable PPAT Assessment Permission Form for Students Under 18 (ETS)

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PPAT Assessment Permission Form for Students Under 18 (ETS)

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Copyright © 2020 by Educational Testing Service. All rights reserved.
ETS, the ETS logo and PPAT are registered trademarks of Educational Testing Service (ETS) in the United States and other countries.
PPAT
®
Assessment
Permission Form for Students Under 18
Last Updated 4/22/20
Dear Parent/Guardian:
I am a candidate taking the PPAT
®
assessment required by my educator preparation program (named
below). As part of my assessment responses, I would like to submit samples of your child’s work as
evidence of my teaching practice. Your child’s name will not appear on any materials that are submitted.
I will also submit a short video recording of my teaching. Although your child and other students in the
classroom may be included in the video recording, the primary focus is on my instruction, not the students
or other adults in the class.
My responses, including all written commentary, student work samples and video that I submit, will be
viewed by ETS raters while scoring my assessment. These responses may also be used to train new ETS
raters for the scoring of future assessments. My educator preparation program may also review my
responses to help me improve my teaching performance. My written commentary may be used by ETS in
the development of a library of examples for future teacher candidates. The library will not include the
student work samples and video.
Please complete the information below and check the appropriate boxes to document your permission for
submitting your child’s work and including your child in a video recording.
Your Name: ____________________________________________________________________
Your Child’s Name: _______________________________________________________________
Your Address: ___________________________________________________________________
School Your Child Attends: _________________________________________________________
Student Teacher’s Name: __________________________________________________________
Student Teacher’s Educator Preparation Program and State: ______________________________
I am the parent/legal guardian of the child named above. I have read the information above
regarding the PPAT Assessment being administered by ETS and agree to the following:
Materials (check one)
󰐉 I DO give permission to submit materials that my child has completed as part of classroom activities.
󰐉 I DO NOT give permission to submit materials that my child has completed as part of classroom
activities.
Video Recording (check one)
󰐉 I DO give permission to include my child in video recordings of classroom activities.
󰐉 I DO NOT give permission to include my child in video recordings of classroom activities.
Signature of Parent/Guardian: _____________________________________ Date: ______________
Copyright © 2020 by Educational Testing Service. All rights reserved.
ETS, the ETS logo and PPAT are registered trademarks of Educational Testing Service (ETS) in the United States and other countries.
Formulario de permiso para alumnos menores de 18 años
para la Evaluación PPAT
®
Última actualización 22/4/20
Estimado padre/madre o tutor(a):
Soy un/a candidato/a que va a tomar la Evaluación PPAT
®
, la cual es un requisito de mi programa de
preparación de maestros (que se menciona abajo). Como parte de mis respuestas a la evaluación, quisiera
presentar ejemplos del trabajo de su hijo(a) como prueba de mi práctica docente. El nombre de su hijo(a)
no figurará en ninguno de los materiales que se presenten. También presentaré una grabación corta en
video de mi enseñanza. A pesar de que su hijo(a) y otros alumnos en el aula podrían estar incluídos en la
grabación, su enfoque principal es en mi enseñanza y no en los alumnos u otros adultos en la clase.
Los evaluadores de ETS verán mis respuestas, incluyendo todos los comentarios por escrito, los ejemplos
de trabajo de los alumnos y el video que presente, mientras califican mi evaluación. Estas respuestas
también podrían ser utilizadas para capacitar a nuevos evaluadores de ETS para que puedan calificar
futuras evaluaciones. Mi programa de preparación de maestros también podría revisar mis respuestas
para ayudarme a mejorar mi desempeño docente. Mis comentarios por escrito podrían ser usados por ETS
para desarrollar una biblioteca de ejemplos para futuros candidatos a maestros. La biblioteca no incluirá
ejemplos de trabajo de los alumnos y el video.
Por favor llene la información de abajo y marque las casillas apropiadas para documentar si usted da
permiso o no para presentar el trabajo de su hijo(a) e incluir a su hijo(a) en una grabación en video.
Su nombre: ____________________________________________________________________
Nombre de su hijo(a): ____________________________________________________________
Su dirección: ___________________________________________________________________
Escuela a la que asiste su hijo(a): __________________________________________________
Nombre del/de la maestro/a practicante: _____________________________________________
Programa estatal de preparación de maestros practicantes: ______________________________
Soy el padre/la madre/el(la) tutor(a) legal del/de la niño(a) que se nombra arriba. He leído
la información de arriba en cuanto a la Evaluación PPAT que está realizando ETS y accedo a
lo siguiente:
Materiales (marque uno)
󰐉 DOY permiso para incluir materiales que mi hijo(a) haya completado como parte de actividades
en clase.
󰐉 NO DOY permiso para incluir materiales que mi hijo(a) haya completado como parte de actividades
en clase.
Grabación en video (marque uno)
󰐉 DOY permiso para incluir a mi hijo(a) en grabaciones de video de actividades en clase.
󰐉 NO DOY permiso para incluir a mi hijo(a) en grabaciones de video de actividades en clase.
Firma del padre/la madre/el(la) tutor(a): _____________________________ Fecha: _____________
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PPAT Assessment Permission Form for Students Under 18 (ETS)

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Completed 4 January 2022

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