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Procedure for Approval of Surveys Form

  • Education Agency Relations: L
Procedure for Approval of Surveys Form
Updated

Use of Surveys in School District 27J Form – ILA – R2

Please refer to School District 27J Board Policy ILA – R1

Please submit the following form and requested information to the Director of Assessment 2 months prior to the earliest date on which you would like to administer the survey.

  • Date____________________________________________
  • Name of the survey:_______________________________

Please attach a copy of the survey

  • Name of the school where you work: _______________________________________________
  • Your position within the school: _______________________________________________
  • If you have a district assignment, please name the department for which you work: _______________________________________________
  • The target group by grade level: _______________________________________________
  • Estimated number of students who would be involved: _______________________________________________
  • Briefly state your purpose for having students complete the survey: _______________________________________________ ______________________________________________________________________________________________
  • Submit a dated, signed statement from your principal or supervisor that they are aware of, and approve of, your intention to administer this survey
  • Submit your parent information letter about the survey, which includes written permission for the student to participate if there any questions “about parents’ or students’ beliefs or practice in sex, family life, morality, and religion.”
  • Indicate if your survey “is answered anonymously by the student” and you are seeking Board Approval for an exemption to the parent permission requirement because the survey will be used “as a means of evaluating an area of the school curriculum or program that is of specific concern or responds to a particular educational need with the school district”.
  • Please briefly indicate how your survey fits the exemption criteria: _____________________________________________________________________________________________________________________________________________

Within one week of the receipt of the survey and supporting documents you will be notified about district permission to proceed with the administration.

If your request to survey is not approved, you will be sent an explanation in writing with suggestions for adjustments that can be made in order to receive approval. After adjustments are made the request can be resubmitted.