Social Emotional Learning Screener Opt Out Form

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To view the SEL Screener questions, along with information about this screener, click on this link: https://www.cpsd.us/cms/One.aspx?portalId=3042869&pageId=69179517

The Cambridge Public Schools administers a social emotional learning screener to assess the social emotional learning of students. This assessment is utilized by your child’s school as a universal screener to help teachers with the developmental profiles of their students so that classroom instruction can be better designed and differentiated and students be better supported in their learning. It is not being used to evaluate your child’s eligibility for any supports or services under either a Section 504 Plan or an Individualized Education Program. You have a right to inspect this screener and may do so by making a written request to the principal/head of upper school of your child’s school. You also may elect to not have your child participate in taking this social emotional learning screener by informing the principal/head of upper school in writing or by completing this Opt Out form.

If you DO want your child to participate in this screener, you do not need to complete this form.

Opt Out Form *

I do NOT want my child to participate in the administration of the social emotional screener.

Required

Parent/Guardian First Name *

By typing your name below you are opting out of your child participating in this screener.

Parent/Guardian Last Name *

Child #1 - First Name *

Child #1 - Last Name *

Child #1 - Student ID

Child #1 - School in September 2019 *

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