- J
- Students
File: JRSU-E (pdf)
Adopted: Date of Manual Adoption
CONSENT FOR SUBMISSION TO SURVEYS,
ANALYSES, OR EVALUATIONS
In some circumstances in which a student is to be required to submit to a survey, analysis, or evaluation, the school must receive written parental consent prior to the activity.
A "survey," "analysis," or "evaluation" means a method of obtaining information, including a group activity, that is designed to elicit information about one or more of the following seven protected areas:
- political affiliations;
- mental and psychological problems potentially embarrassing to the student or his or her family;
- sex behavior and attitudes;
- illegal, anti-social, self-incriminating, and demeaning behavior;
- critical appraisals of other individuals with whom respondents have close family relationships;
- legally recognized privileged and analogous relationships, such as those of lawyers, physicians, and ministers; or
- income (other than that required by law to determine eligibility for participation in a program or for receiving financial assistance under such program).
CONSENT FORM FOR SUBMISSION TO A SURVEY,
ANALYSIS, OR EVALUATION
On , your child will be asked to .
Please complete this form and return to School by .
Feel free to call at
if you wish to discuss this activity before signing the form.
[ ] I give my consent for
to participate in a survey, analysis, or evaluation, as described above. I understand that my student may choose not to respond to any portion of, or withdraw from the activity at any time.
[ ] I do not give my consent for
to participate in a survey, analysis, or evaluation, as described above. I understand that my student will be given an academic alternative in a manner that does not call particular attention to my student or my student's family.
Date
Signature of Parent/Guardian
(or of Student if an emancipated minor or 18 years of age or older)