Permission form: Student record release

This form is specifically used to indicate that you (as a parent or guardian) wish to allow the instructor to submit a record of your student's work (without any identifers) for the purpose of demonstrating my skills as a teacher. 

You may also indicate that you do not wish to give this permission. The form should be returned in either case. 

Elements that I must submit: 

A record of your student's image on video during class 

A record of your student's voice on video during class 

Copies of materials that your student has produced or may produce as part of class activities,

My submissions (the Submissions) will also include my written commentary sheets, instructional materials, essays, classroom plans, assignments, and commentary.

All on the terms and conditions described below:

1. Your student’s last name will not appear on or in any recordings, photographs or school works that are submitted to the National Board.

2. The National Board may use the materials that you submit to the National Board only for the purposes and on the terms described in the Letter.

3. The National Board may disclose copies of the materials that you submit to the National Board: (a) to individuals who access a National Board password-protected database for educational, research or professional development purposes; and (b) in National Board works or publications in which such materials might be included.


I am not able to edit the recordings in any way. 

Recordings will be stored in a secure hard drive prior to submission. I will keep them secured for my future practice.

Student_Release_Form_English.pdf, 518.23 KB; (Last Modified on September 3, 2019)