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Sample Permission-to-Excuse Letter
This sample letter is designed to help the principal decide whether or not to recommend to the
superintendent that approval be given to excuse a student from writing an achievement test.
Simple modifications to the letter could be made as the situation warrants.
TO:
Parent/Guardian
Date
RE:
Name of Student
In May and June of this year, students in grades 6 and 9 throughout the province will write
provincial achievement tests in four subject areas: language arts, mathematics, science, and social
studies. Students in the grade 9 Knowledge and Employability courses will write the Knowledge
and Employability pilot tests in the four core subjects. Students in Grade 3 will write tests in
language arts and mathematics. Results from these tests will provide Alberta Education, school
administrators, teachers, parents, students, and the public with information about what students
know and can do in relation to provincial standards at the end of grades 3, 6, and 9. These results
can be used to improve learning opportunities for students.
Test accommodations are available for students with learning disabilities or physical disabilities
to allow these students to do their best. However, a superintendent should excuse a student from
writing an achievement test if the student is not capable of responding to the test in its original or
approved modified form, or if participation would be harmful to the student. The
superintendent’s decision to excuse a student from completing one or more of the achievement
tests is based on a recommendation from the principal, accompanied by supporting
documentation.
I am considering recommending to the superintendent that your child be excused from writing the
provincial achievement test(s) in the following subject(s):
Language Arts—Writing
Mathematics
Science
Language Arts—Reading
Social Studies
Please indicate your response below and return this letter.
I agree with the proposal to excuse my child.
I do not wish my child to be excused from writing.
I would like an opportunity to discuss this recommendation.
Principal’s Signature
Parent/Guardian’s Signature
School
Date
SAMPLES/FORMS/LETTERS
November 2007
1
Sample Letter to Parents
This sample letter assumes that the classroom teacher has decided to use the achievement test in
determining students’ final grades. Simple modifications to the letter could be made if this is not
the decision.
To Parents of Students in Grades 3, 6, and 9:
In May and June of this year, all Grade 3 students throughout the province will write provincial
achievement tests in language arts and mathematics. Students in grades 6 and 9 will write tests
in four subject areas: language arts, mathematics, science, and social studies.
I will mark the tests before they are returned to Alberta Education so as to get an initial look at
the performance of the students in my class. The tests cover what students have been learning
this year fairly well, so I will be using your child’s score as ___ percent of the final grade. The
final grade will represent your child’s overall performance in the full range of learning outcomes.
In the fall, an Individual Student Profile showing your child’s achievement test results will be
available at our school. The profile is prepared by Alberta Education when the marking of tests
has been completed and final scores are tabulated. The profile will show your child’s
performance on each test in relation to provincial standards. This information can be useful in
planning your child’s instructional program for the coming year. You are invited to review your
child’s results with his or her new teacher and to discuss how results will be reflected in the
instructional program that is planned for the coming year.
Reports that show how well our students did as a group in relation to provincial standards will
also be available at our school in the fall. All parents and other members of our community will
be invited to our school to discuss the results at that time.
Please call our school if you have any questions.
SAMPLES/FORMS/LETTERS
November 2007
2
REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 3—May/June 2008
Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed,
forward to the Superintendent, for sign-off and return to Learner Assessment.
SCHOOL:
______________________________
JURISDICTION: ______________________________
SCHOOL CODE:
___________
JURISDICTION CODE: ____________
For each subject, indicate the quantity of materials required.
Gr. 3 ELA
CD version
Gr. 3 Math
Timed Number
Facts
Gr. 3 Math
English
Gr. 3 Math
French
Gr. 3 FLA
Gr. 3 Français
Not available
Large-print version
Braille version
Not available
Other, Specify
Not available
Not available
Not available
Not available
(e.g., colour of paper)
Comments:
Note: If you have any questions about this form, contact the Special Cases/Accommodations Team
at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at
special.cases@gov.ab.ca.
Date
Telephone Number
Principal’s Signature
Date
Superintendent’s Signature
Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at
10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889
SAMPLES/FORMS/LETTERS
August 2007
3
REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 6—May/June 2008
Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed,
forward to the Superintendent, for sign-off and return to Learner Assessment.
SCHOOL:
______________________________
JURISDICTION: ______________________________
SCHOOL CODE:
___________
JURISDICTION CODE: ____________
For each subject, indicate the quantity of materials required.
Gr. 6 ELA
Gr. 6 Soc. St.
English
French
Gr. 6 Math
English
French
Gr. 6 Science
English
French
Gr. 6 FLA
Gr. 6 Français
CD version
Large-print version
Braille version
Not available
Not available
Other, Specify
(e.g., colour of paper)
Comments:
Note: If you have any questions about this form, contact the Special Cases/Accommodations Team
at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at
special.cases@gov.ab.ca.
Date
Telephone Number
Principal’s Signature
Date
Superintendent’s Signature
Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at
10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889
SAMPLES/FORMS/LETTERS
August 2007
4
REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 9 Semester—January 2008
Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed,
forward to the Superintendent, for sign-off and return to Learner Assessment.
SCHOOL:
______________________________
JURISDICTION: ______________________________
SCHOOL CODE:
___________
JURISDICTION CODE: ____________
For each subject, indicate the quantity of materials required.
Gr. 9 ELA
Gr. 9 Soc. St.
English
French
Gr. 9 Math
English
French
Gr. 9 Science
English
French
Gr. 9 FLA
Gr. 9 Français
CD version
Large-print version
Braille version
Not available
Not available
Other, Specify
(e.g., colour of paper)
Comments:
Note: If you have any questions about this form, contact the Special Cases/Accommodations
Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at
special.cases@gov.ab.ca.
Date
Telephone Number
Principal’s Signature
Date
Superintendent’s Signature
Note: November 2, 2007, is the deadline for returning this form to Learner Assessment at
10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889
SAMPLES/FORMS/LETTERS
August 2007
5
REQUEST FOR SPECIAL FORMAT MATERIALS
GRADE 9—May/June 2008
Provincial Achievement Tests
This request is to be completed only if you require special format materials. Once completed,
forward to the Superintendent, for sign-off and return to Learner Assessment.
SCHOOL:
______________________________
SCHOOL CODE:
___________
JURISDICTION:
______________________________
JURISDICTION CODE:
____________
For each subject, indicate the quantity of materials required.
Gr. 9 ELA
Gr. 9 Soc. St.
English
French
Gr. 9 Math
English
French
Gr. 9 Science
English
French
Gr. 9 FLA
Gr. 9 Français
CD version
Large-print version
Braille version
Not available
Not available
Other, Specify
(e.g., colour of paper)
Comments:
Note: If you have any questions about this form, contact the Special Cases/Accommodations
Team at (780) 427-0010, for a toll-free connection, dial 310-0000, or e-mail at
special.cases@gov.ab.ca.
Date
Telephone Number
Principal’s Signature
Date
Superintendent’s Signature
Note: March 28, 2008, is the deadline for returning this form to Learner Assessment at
10044 – 108 Street, Edmonton, AB T5J 5E6. Fax: (780) 422-4889
SAMPLES/FORMS/LETTERS
August 2007
6
Achievement Testing Program 2007–2008
Shipment 1 Verification Form
Fax this form if you have problems with the shipment or
have additional requirements.
School Code:
School Name:
School Contact Person:
School Phone #:
Testing Session:
School Fax #:
January (Grade 9 only)
June
Please check the subject(s) and indicate problem or requirement
Subject
Problem
Requirement
ELA 3 Part A
FLA 3 Partie A
Fr 3 Partie A
Timed Number Facts 3
ELA 6 Part A
FLA 6 Partie A
Fr 6 Partie A
Mathematics 6 Part(ie) A
ELA 9 Part A
K&E ELA 9 Part A
FLA 9 Partie A
Fr 9 Partie A
Fax this form to the Marking Centre at (780) 422-8323.
SAMPLES/FORMS/LETTERS
August 2007
7
Achievement Testing Program 2007–2008
Shipment 2 Verification Form
Fax this form if you have problems with the shipment or
have additional requirements.
School Code:
School Name:
School Contact Person:
School Phone #:
Testing Session:
School Fax #:
January (Grade 9 only)
June
Please check the subject(s) and indicate problem or requirement
Subject
Problem
Requirement
ELA 3 Part B
FLA 3 Partie B
Fr 3 Partie B
Mathematics 3
ELA 6 Part B
FLA 6 Partie B
Fr 6 Partie B
Mathematics 6 Part B
Science 6
Social 6
ELA 9 Part B
K&E ELA 9 Part B
FLA 9 Partie B
Fr. 9 Partie B
Mathematics 9
K&E Mathematics 9
Social 9
K&E Social 9
Science 9
K&E Science 9
Fax this form to the Marking Centre at (780) 422-8323.
SAMPLES/FORMS/LETTERS
August 2007
8
Statement of Scribe, Reader and/or Interpreter
and Principal—Grades 3/6/9 Achievement Tests
I,
and
Scribe/Reader/Interpreter (please print)
Principal (please print)
Scribe
Reader
Interpreter
having read the procedures governing the use of ,
certify that to the best of our abilities
the achievement test(s) in
Subject(s)
during the
held at
School
, 2008
month
testing period for
Student’s name (please print)
was administered and supervised in accordance with the specified procedures under the
directives of the Minister of Education.
was administered and supervised in accordance with the specified procedures under the
directives of the Minister of Education, except as follows:
Dated this
day of
, 2008
Scribe’s/Reader’s/Interpreter’s Signature
Principal’s Signature
School Code
Please sign and return with the Principal’s Statement.
If more than one individual is providing accommodation services to one student, please fill
out separate forms.
SAMPLES/FORMS/LETTERS
August 2007
9
Example of the Back of a Written Response Booklet
Example of the Back of the Test Booklet
Please place the label on the back of the Readings Booklet
GRADE 3 ENGLISH LANGUAGE ARTS
Part B
To be completed by/for ALL students.
Last Name (please print)
C
First Name
To be completed ONLY for students without labels.
Name
Alberta Student Number
School Name
Birth Date (Year/Month/Day)
ACCOMMODATIONS USED
(mark all applicable)
1
6
2
7
3
Apply Label With Student’s Name
School Code
Sex:
COMPLETED THE COURSE
IN A YEAR OTHER THAN
THE YEAR OF TESTING
M
F
HOME EDUCATED FOR THIS SUBJECT
8
4
9
5
10
PAT0300001M.02
SAMPLES/FORMS/LETTERS
August 2007
10
Sample of the Back of the Timed Number Facts
The chart below outlines the number and description of the labels that will be sent for each
achievement test administration.
Grade/Subject
Grade 3
ELA, FLA and Français
Part(ie) A Tests
Number of Labels
Description
2 per booklet
One with student name
One without student name
ELA—Part B
Timed Number Facts
Multiple Choice
Grade 6
ELA, FLA and Français
Part(ie) A Tests
1 per booklet
1 per booklet
1 per booklet
With student name
With student name
With student name
2 per booklet
One with student name
One without student name
Mathematics Part(ie) A
1 per booklet
1 per answer sheet
With student name
With student name
All Machine Scored Tests
1 per booklet
1 per answer sheet
With student name
With student name
2 per booklet
One with student name
One without student name
1 per booklet
1 per answer sheet
With student name
With student name
Grade 9
ELA, FLA & Français
Part(ie) A Tests and the
K&E Part A Pilot Test
All Machine Scored Tests
and the K&E Pilot Tests
SAMPLES/FORMS/LETTERS
November 2007
11
SAMPLES/FORMS/LETTERS
12
August 2007
ELA 3
Part A
FLA 3
Part A
Fr 3
Part A
Math 3
Part A
Math 3F
Part A
4
4
4
4
4
+
+
+
+
+
0
1
0
0
0
Absent(A)
+
+
+
+
+
+
+
+
+
+
1
1
1
1
1
Transferred(T)
“+”signs are included to assist
with accurate completion of
this sheet.
1
1
1
1
1
Excused(E)
Tests NOT Completed by Students
Principals MUST return this signed List of Students even if NO students took part in the testing.
+
5
+
5
+
+
5
4
+
5
Unregis. Students
Tests Completed for
The New Century School (403) 321-4321
Alberta School Division No. 99
Regis. Students
School:
9999
Authority: 0000
June 2008 Achievement Tests
LIST OF STUDENTS #1
Grade 3
=
=
=
=
=
11
11
11
11
11
TOTAL
SAMPLES/FORMS/LETTERS
13
August 2007
Appleyard, Mary
Browning, Peter
Copeland, Robert
Dickens, Aaron
Emerson, Charlene
Frost, Robert Wayne
Highliner, Deanne
Nighthood, Chris
Student Name
Surname, Given
Names
F
M
PERCY, LINDA
(HOME ED)
NELSON, RANDY
(OUT OF GRADE)
1001-7432-1
1011-6941-5
This student is not in
Grade 3.
M
F
SMITH JEFFREY
RAINE, SUSAN
9607-8901-7
9702-5713-8
F
M
M
M
F
M
F
M
Sex
3
3
3
3
3
3
3
3
3
3
T
E
T
E
T
E
3
3
A
3
3
3
3
3
Fr 3
Partie A
3
3
FLA 3
Partie A
ELA
Part A
These four students are unregistered and
have been added to the List of Students.
1997-05-10
1997-01-19
1998-07-17
1997-02-14
1997-12-19
1998-01-09
1997-11-10
1996-11-02
1997-06-22
1997-02-09
1997-04-29
1997-09-04
Birth
Date
Math 3F
Part A
3
3
3
3
3
T
E
This student transferred.
T
E
The Superintendent excused (E)
this student from writing the
Achievement Tests.
3
3
3 This student transferred.
3
3
Math 3
Part A
This student received instruction
in French and wrote in French.
The New Century School (403) 321-4321
Alberta School Division No. 99
This student is a “Home Education”
1056-1387-1
9801-0002-3
9711-6742-3
1002-6534-4
1007-0122-3
9702-3659-1
9704-7432-1
1007-0931-1
Alberta Student
Number
School:
9999
Authority: 0000
June 2008 Achievement Tests
LIST OF STUDENTS #1
Grade 3
SAMPLES/FORMS/LETTERS
14
August 2007
The New Century School
Alberta School Division No.99
8b. The following irregularities (including violation of the test rules) occurred during the administration of the tests:
____________________________________________________________________________________________
____________________________________________________________________________________________
OR
8a. The tests were administered without incident or irregularities, and without violation of test rules.
7. Each test area was free from internal and external distractions.
tests on the school’s computers. Note: Please put NA in box #6 if your school did not use this provision.
6. I am satisfied that my school complied with all achievement test writing rules and procedures for administering achievement
and valid evaluation of students’ achievement.
5. I am satisfied that the level of supervision during the writing of the achievement tests was acceptable and allowed for a fair
4. All calculators were cleared to ensure that no information was stored in programmable or parametric memory.
and 9 tests were inspected before use.
3. Materials allowed for Part(ie) A of English Language Arts 3, 6, and 9 and Français 3, 6 and 9 and French Language Arts 3, 6
Year Achievement Testing Program General Information Bulletin.
2. I discussed with supervising teachers key aspects of supervising Achievement Tests as described in the 2007-2008 School
1. Test cartons were resealed and locked in a secure storage facility after verification of the test shipment.
Before Administration
The duties and responsibilities of the principal when administering the June 2008 Achievement Tests are described in the
2007-2008 School Year Achievement Testing Program General Information Bulletin. The Principal’s Statement serves to certify that these
duties and responsibilities have been fulfilled. Please check (3) each box (where appropriate) to indicate that, as principal, you have
followed these procedures.
School:
9999
Authority: 0000
(English Language Arts 3 Part A & B, French Language Arts 3 Partie A & B, Français Language Arts 3 Partie A & B,
Mathematics 3 Part A, Mathématiques 3 Part A)
June 2007 Provincial Achievement Tests
Principal's Statement #1 Grade 3
SAMPLES/FORMS/LETTERS
15
November 2007
Summer Contact (please print)_________________________________
School Phone # ____________________________
Note: The return of a completed Principal’s Statement, with each List of Students (LOS), even if no student wrote the examination, is
a mandatory requirement of Alberta Education
Summer Phone Number___________________________
School Code ______________________
School________________________________________________________________________________________
Date_________________ Principal's Name (please print)_____________________ Principal's Signature__________________________
Declaration:
I hereby certify that in my capacity as principal I carried out my duties and responsibilities as required by the 2007-2008 School Year
Achievement Testing Program General Information Bulletin. I attest that no secured achievement test materials were copied in whole or
in part in any manner or have been retained at the school, and that all Teacher Perusal Copies are enclosed with the Principal’s
Statement.
All other tests
For return of Shipment 2:
Grade 6 Mathematics Part A: Operations and Number Sense
Grade 3 Mathematics: Timed Number Facts
Language Arts: Part(ie) A
For return of Shipment 1:
Achievement Testing Program General Information Bulletin.
9. The test materials were prepared for return to the Learner Assessment according to the 2007-2008 School Year
Following Administration