CHKS

Thursday, Oct. 27, 2007, via grade 7 Science Classes
Make-ups: Friday, Oct. 26, 2007
For 7th graders who do not take Science, the survey will be administered in
an alternative setting, or the students will take the survey in one of the science classes

Healthy Kids Survey Permission/NonPermission Letter to Parents
En Español, Carta de Permiso o No Permiso a los Padres

Grade 7 students are being asked to be a part of Colina Middle School's Healthy Kids Survey, sponsored by the California Department of Education. This is a very important survey that will help the District promote better health among our community's youth and combat problems such as drug abuse, tobacco use, and violence. The survey has also been approved by the Department of Alcohol and Drug Programs, Office of the Attorney General and Department of Health Services. Your written permission on this form is required in order for your child to participate in the surrey. The following are facts to help you make your decision:

Survey Content. The survey will gather information on heaith-risk behaviors such as physical activity and nutritional habits; alcohol, tobacco, and other drug use; and violence, gang membership, and delinquency. There are no questions about family values. You may examine the questionnaire in the school office. It will take about one class period to complete; the test will be administered via grade 7 science classes.

Student Selection. Students in grades 7, 9 and 11 have been selected for this survey.

It is Voluntary. Your child does not have to take the survey. There will be no actions or penalties against you or your child for not participating. Students only have to answer the questions they want to answer and they may stop taking it at any time. Before the survey begins, the survey's purpose, content, and procedures will be explained again. Your child will be able to ask questions and decline to participate.

It is Anonymous and Confidential. Your child's privacy is protected. No names will be recorded or attached to the survey. No information will permit your child to be identified or connected with his/her answers. Survey administrators have signed pledges of confidentiality.

Where to Turn for Further Information. If you have questions about this survey, or about your rights, you may call the Healthy Kids Survey center at no charge at (888) 841-7536. The survey is being conducted by WestEd, a public, non-profit educational institution.

Written Parent/Guardian Permission Required. Each student's parent/guardian needs to indicate whether or not the student has permission to participate in the survey. A letter to take home is being distributed to your student in Science class (if the student doesn't take Science, the parent letter will be distributed through Directed Studies, Passport to Reading or Passport to Math). On this letter the parent is asked to check one one the items: I give permission for my child to be in the Healthy Kids Survey; or I do not give permission for my child to be in the Healthy Kids Survey. The parent needs to please sign the letter, and give it to the student to return to science class within three days. If somehow you have not received the permission/non-permission letter, you may download it here.