5440F - Student Teacher Video Audio Opt Out-English Form

Form 5440F

PERSONNEL 

Form 5440F

OPT-OUT FORM FOR VIDEO/ AUDIO

STUDENT TEACHER IN THE CLASSROOM

 

Dear Parent/ Guardian:

Your student may have a “student teacher” in their classroom this year. To become a teacher in Washington, the student teacher must show they are ready to teach by:

·         Planning Lessons
·         Teaching and video/audio recording lessons
·         Grading student work

Video/ Audio recordings of the Student Teacher and the classroom will be shared with trained reviewers outside the school. It may also be used to train other student teachers, faculty and staff. Student names will be removed from all the work shared.

Please complete this form if you do NOT give permission for your student to appear in the video/audio recordings of Student Teachers. If you do not give permission, your child will still participate in the lesson but will be seated out of camera range.

 

Student Name: _________________________________________________________________

 

I am the parent/ legal guardian of the student named above. I have received and read the letter above and I DO NOT give permission to video/audio record my student.

Signature of Parent/Guardian:

 

__________________________________________________           _______________________

Signature                                                                                                Date

 

__________________________________________________  

Printed Name