South Whidbey Assessment Refusal Form

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This form is used to document parent/guardian request to have students not participate in assessments. This form needs to be completed annually.

Email *

Student Last Name *

Student First Name *

Student Grade *

Federal and state laws require public schools to administer annual tests to students enrolled in specified grades and subjects. Schools also give grade-level interim assessments in addition to the classroom assessments given by teachers. The intent of completing this form is to provide an opportunity to ensure that: *

I Understand - Parents/guardians are informed of the role of assessment in attaining educational outcomes.

I Understand - This form is used for documentation in instances when parents or guardians refuse to have their children participate in district or state testing.

I Understand - Test accommodations and supports are available for students as needed.

I Understand - The benefits of testing and consequences of not testing are known to parents/guardians.

I Understand - The principal has documentation to note why test scores will not be available and that an attempt was made to make parents/guardians aware of the consequences of the test refusal.

I Understand - Schools are not obligated to provide alternate lessons or learning experiences for students refusing to test during the time that the state or district tests are being administered. However, schools must provide supervision for students who are attending school but not participating in testing.

I Understand - Parents/guardians have an opportunity to share any concerns and reasons for the test refusal.

Required

As the parent or guardian of the above named student, I refuse to have my child participate in the following tests this school year: *

Smarter Balanced ELA (Grades 3-8 & 10)

Smarter Balanced Math (Grades 3-8 & 10)

WCAS (Washington Comprehensive Assessment of Science) - (Grades 5, 8 & 11)

WIDA Screener (Grades K-12 - English Language Learners)

WA-KIDS (Washington Kindergarten Inventory of Developmental Skills) - Kindergarten Only

WA-AIM (Alternative Assessment) - (Grades 3-8 & 10 - Special Education)

i-Ready Benchmarks - (Grades K-8)

Other:

Required

Benefits to Students for Taking District and State Assessments include the following: 1-Assessments measure critical learning standards, including communication, reasoning, problem solving, and application of knowledge and skills in new situations. 2-Each test provides a report on students’ progress toward college and career readiness in English language arts/literacy, math and science. This includes performance indicators of strengths and weak areas within each subject area. 3-Teachers gain information about students’ progress toward meeting grade-level expectations in the core academic areas of English language arts, literacy, math, and science, and can plan instruction accordingly. 4-In addition to measuring progress toward proficiency of learning standards aligned to college and career readiness, success on the High School Smarter Balanced tests may result in direct access to college level math and English classes when students enroll in technical or community colleges. 5-Through a request to the state, parents can view their child’s answers on their completed state tests to gain a deeper understanding of how their child is progressing on state standards. 6-Because assessments measure students’ progress toward meeting standards, information regarding the performance of groups of students helps district staff make decisions about the effectiveness of various instructional programs. The consequences when students Do Not Take the State Assessments. 1-Teachers and staff lack full information about the instructional needs of students who do not participate in student assessment, which could lead to some students not receiving all the instructional support they may need to be successful in school. 2-Schools and programs lose information that informs instructional program effectiveness and monitoring progress toward increasing equitable access for all students. 3-Passing state tests in English language arts and math is one way students can meet their high school graduation pathway requirements. 4-Students who do not attempt the high school state tests close that pathway to graduation. *

I have read the benefits and consequences listed above.

Required

I have read the benefits for students taking the district and state assessments and the consequences of not participating. My reason(s) to refuse my child’s participation in the above tests are per the following: *

Parent/Guardian Name *

Parent/Guardian Email *

Send me a copy of my responses.

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