Policy IKA-E – Parent Request for Exemption from State/Federal Assessments

File: IKA-E

Parent Request for Exemption from State/Federal Assessments

NOTE: This policy is a form. Below is the text format of the form, however please use PDF version of this form:  IKA-E – Parent Request for Exemption from State-Federal Assessments

Huerfano School District Re-1
2020-2021 School Year

Please complete this form and return to the building administrators. This form is valid for the designated school year only.

I request that my child, _____________________________, grade ________ be exempt from taking the following Colorado State Assessments or Federal Assessments for the __________________school year.

The form is available here as a PDF: IKA-E – Parent Request for Exemption from State-Federal Assessments

*Please indicate the assessments below with an x to opt your child out from participation.

Assessments in the following content areas:
_____ English Language Arts
_____ Math
_____ Science
_____ Social Studies
_____ PSAT
_____ SAT
_____ ALL Assessments
I am requesting an exemption for my child because: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please initial the box below:
__________ I acknowledge that the school district or building level administration has neither asked me to “opt in” my student for state assessment participation or encouraged me to “opt out” my student from state assessment participation. I do understand that the state prefers a 95% participation rate for testing and that the assessments will provide me with information concerning my child’s academic progress and growth in the areas tested as well as my child’s progress toward college and career readiness.

_________________________________________      _____________________
Print Name                                                                      Date

________________________________________________
Signature