ASSENT FORM 2

(Student-Participant Aged 13 to 17)

This is to acknowledge that I, _______________________________, am invited to participate in this
online testing that will be conducted by the Rex Institute for Student Excellence (RISE) for the
Digital Assessment of Competencies and Excellence of Students (ACES).

I understand that the intention of my participation in this testing is to help the company produce a
high-quality assessment tool that could capture my ability and, in a way, would represent my
language and the situations that I am in. Hence, my participation should not in any way affect my
performance evaluation in the class.

I understand that the school and the company will not provide devices and/or internet connection that
I will be using during the assessment. The company will only provide an online platform that will
allow me to experience answering standard – based 21st century digitalized assessment tools.

I understand that my identity will not be revealed in any document that shows the results of this
testing. I am aware that the company will use my data only to generate the account that I will be using
in the platform and for the post data analysis.

I understand that my participation is completely voluntary and that I can withdraw from participating
anytime I feel the need to do so.

I have read and understood the conditions for this online testing.

I, ________________________________, will __ participate/ __ not participate online testing.

For Parents: This is to attest that my son/daughter has read and understood this Assent Form. In line
with this, I am ___ allowing/ ___ not allowing him/her to be part of this online test.

_______ ______
Signature over Printed Name of the Participant Date Signed

_______
Signature over Printed Name of the Parent/Guardian Date Signed

Relationship to the participant_____________________________

STUDENT DATA FORM

SCHOOL
SCHOOL ADDRESS
TYPE OF SCHOOL PRESENT GRADE LEVEL SECTION
Private Public
CLASS ADVISER
NAME
Last Name First Name M.I. Auxiliary Name
BIRTH DATE GENDER: Male Female
Month Day Year
RELIGION
Roman Catholic Christian Protestant Buddhist
Muslim Other: Please, specify:
REGION LANGUAGE SPOKEN AT HOME (Choose all applicable)
1 Tagalog Chavacano
2 Kapampangan Ivatan
3 Pangasinan Sambal
CALABARZON Iloko Aklanon
MIMAROPA Bicol Kiniray-a
5 Ybanag Yakan
6 Sinugbuanong Binisaya Sinurigaonon
7 Hiligaynon English
8 Waray Chinese
9 Bahasa Sug Others: Please specify:
10 Maguindanaoan
11 Maranao
12
NCR CONTACT DETAILS
CAR Student Parent/Guardian
ARMM Mobile
CARAGA Number
I

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