Saint Mary’s University of Minnesota
Master of Education in Teaching and Learning Program
Permission to use Student work for Professional Development
(This form must be completed by parents/guardians of students whose classroom participation and/or work may be included as evidence of the teacher’s professional development)
Dear Parent/Guardian:
During the ______academic year I am gathering information from my classroom as part of my participation in the Saint Mary’s University Master of Education in Teaching and Learning program. The main purpose for my involvement in this process is to enhance student learning and to strive for excellence in teaching.
Documentation of my learning requires that I submit samples of student work, classroom observation records, surveys, and interviews as demonstrations of my professional growth. These work samples could include some of your child’s work.
As further documentation of my learning, I may also want to include short videotapes of lessons taught in your child’s class. These videotapes would involve both the teacher and some students; however, the focus and emphasis of the tape would clearly be the teacher’s instruction, rather than the students in the class. Your child may appear on one or more of these tapes.
One component of the master’s degree program expectations requires that I place samples of student work in a professional portfolio as documentation of inquiry into my professional teaching practice. In some instances, I may choose to use these learning materials for reference in writing that I submit for publication in professional journals. In such cases, individual learners will remain anonymous.
In all cases, the last names of students will not appear on any materials that are submitted. All materials will be kept confidential. The attached form will be used to document your permission for these activities.
Sincerely,
PERMISSION SLIP
Student Name: ______
Address: ______
School/Teacher: ______
I am the parent/legal guardian of the child named above. I have received and read your letter seeking my permission and I agree to the following:
(Please check the appropriate box below.)
q YES, I DO give permission to reproduce materials that my child may produce as part of classroom activities at ______
(Name of School)
By ______
(Teacher’s Name)
No last names will appear on any materials submitted by the teacher.
q YES, I DO give permission to you to include my child’s image on videotape as he or she participates in a class conducted at
(Name of School)
By
(Teacher’s Name)
No last names will appear on any materials submitted by the teacher
q NO, I DO NOT give permission to reproduce materials that my child may produce as part of classroom activities.
q NO, I DO NOT give permission to videotape my child as part of classroom activities.
Signature of Parent or Guardian Date:
Release Form/Weekend One Documents/Fall 2003