Speak Up Survey

Speak Up Survey

OMB New DoDEA Speak Up Svy-Parental consent

Speak Up Survey

OMB: 0704-0520

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During the school year your child may be asked to participate in surveys that DoDEA has determined will produce useful information to assist in the delivery of a high quality education to your child. Survey participation is anonymous (your child will not be asked to provide his/her name as part of a survey) and survey participation is voluntary and based on your child’s willingness to participate. The surveys in which your child may be asked to participate will explore your child’s experience with and opinions about DoDEA school programs in which he or she is enrolled or participates, his/her participation in the use of various learning technology and equipment, and satisfaction with or achievement in his or her learning. The surveys will NOT engage in the collection of data of a sensitive nature (i.e. information about your child’s or family's health, medical, mental and/or psychological history). In the event that a survey falls outside of these parameters, DoDEA will seek additional specific parental consent.

If you do not want your child to participate in surveys as described above, please check the box below and return this form to your child’s school.

  • I have read this form and my child may not participate in surveys about his/her experience with and opinions about DoDEA school programs.

Child’s name: ____________________________________________ Grade: ____________________

Parent’s signature: _______________________________________

Date: ___________________________

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
Authorshanea.watkins
File Modified0000-00-00
File Created2021-01-27

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