BASB Logo                                                    2022-2023 Consent Form - Please sign and submit

Dear Parent or Guardian,                                                                                                                                              

Your student’s after-school or summer program is part of a citywide project. The project aims to understand the quality of after-school and summer programs in Greater Boston, and how programs can help students grow their skills. Below, you will find more information about the project, which starts in May 2022 and ends in July 2023. Please let us know if your student will participate by checking off ONE box at the bottom and signing this form. Thank you!


What does this project need from my student to understand after-school and summer program quality?

a)       Your student’s information, such as: program attendance, school name, race, gender, grade, age/date of birth, English learner (EL) status, special needs code, home zip code, State Assigned Student Identifier (SASID), and BPS ID. You don’t need to have all of this information. With your permission, this program or the Boston Public Schools (BPS) will provide it.

b)       Your student’s opinion on their experience in this program. This program will use one or more of these short surveys:

×      Survey of Academic and Youth Outcomes (SAYO-Y): Asks about program experience and future plans.

×      Holistic Student Assessment (HSA): Asks questions to understand their social and emotional strengths and needs.

×      Common Instrument (CI): Asks about interest in science, technology, engineering, and math.


Will this information be private?

Yes. All of this data is private and is only used to improve after-school and summer programs. The data is only shared with organizations working on the citywide project: Boston After School & Beyond, BPS, the National Institute on Out-of-School Time (creators of the SAYO-Y), and PEAR Inc. (creators of the HSA and CI). These organizations will not publish anything that includes your student’s name. All information is reported in groups (for example, all 6th grade students who attended summer programs). PEAR Inc. reserves the right to use all HSA and CI data for both research and educational purposes.

Other after-school and summer programs in this project may review your student’s information to confirm whether your student is enrolled in their program. However, these programs will not be able to review your student’s survey responses about their experience at this program.


What else would this project need from my student?


If you agree, Boston After School & Beyond (or their partners/agents) may film or take photos of your student before, during, or after the program. These images may be used to share your student’s participation and perspective to a public audience. These images may be published, posted, or played through a variety of communication channels (for example, television or online).


By typing my name below, I am electronically signing this consent form. I agree to be bound by electronic signatures: