To: Parents & Guardians Topic: Student Release Form - Teacher Performance Assessment Consortium From: Nichio Bryant ~ Student Teacher, (Aubum Mountainview High School) Date: January 1, 2020 | am a student teacher that is involved in an assessment of prospective teachers required by Washington state law to become a teacher. This assessment is part of a twenty-two state consortium overseen by Stanford University and Pearsons, Inc. My participation in this is designed to assist my development in becoming a teacher and is required by Washington State law. This project may include submissions of short video recordings of my teaching in your child's class. Although the video recordings involve both me and various students, the primary focus is upon my instruction, not on the students in the class. In the course of taping, your child may ‘appear on the video recordings. Also, | may submit samples of student work as evidence of my teaching practice, and that work may include some of your child’s work. No student's name will appear on any materials that are submitted. This form continues on the next page and will be used to document your permission for your child's participation in these activities. To: Parents & Guardians Page 2 of 2 ‘Topic: Student Release Form ~ Teacher Performance Assessment Consortium From: Nichio Bryant- Student Teacher, Dustin Hedger — Cooperating Teacher, Auburn Mountainview High Schoo! Terri Herrin — Building Principal Auburn Mountainview High School Date: January 6, 2017 ‘Student Name: Frederick Edwards Jr. ‘Student DOB: 01/09/2003 Street Address: 13116 Southeast 306th Place School: Auburn Mountainview High SchoolCity/State/Zip Code: Auburn Washington 98092 ‘Teacher: Mr. Bryant Tam the parent/legal guardian of the child named above. I have received and read your letter regarding a teacher assessment being conducted by Maryville University, and agree to the following: (Please initial either the I DO or the 1 DO NOT box below.) CYE T.DO give permission to you to include my child’s image on video recordings as he or she participates in class conducted at Aubum Mountainview High School by Mr. Bryant and/or to reproduce materials that my child may have completed as part of classroom activities. No student names will appear on any materials submitted by the student teacher. 1 DO NOT give permission to video record my child or to reproduce materials that my child may produce as part of classroom activities. ature: Carol Date: 1/13/2021 Tam the student named above and am more than 18 years of age. I have read and understand the project description given above. I understand that my performance is not being evaluated by this project and that my last name will not appear on any materials that may be submitted. (Please initial either the IDO or the I DO NOT box below:) FRE TDO give permission to you to include my image on video recordings as I participate in this class and/or reproduce materials that I may produce as part of classroom activities. 1 DO NOT give permission to video record me or to reproduce materials that I may produce as part of classroom activities. oes Frederick Edwards Jr. Date: 01/09/2003 £