Neelsville Middle School Verizon Innovative Learning Project Consent Form

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Please complete this form for each Montgomery County Public Schools (MCPS) student participating in the Verizon Innovative Learning Project. Students eligible to participate in the Verizon Innovative Learning Project must be enrolled in one of the MCPS participating schools. This consent form must be completed and submitted prior to receipt of a device. NOTE: Only students new to Neelsville for SY 2021-22 need to complete this form. Current students that already have an iPad do not need to complete this form a second time. (Spanish-https://bit.ly/VILSPARENTSP) (French- https://bit.ly/VILSPARENTFR)

Email *

Please view this Parent Citizenship Mini Course (https://bit.ly/VILSParent) and select YES as a record of completion. *

Please enter your student's name. *

Please enter your student's ID number.

Please enter your student's date of birth. *

YYYY

Please select a grade level for your student. *

Please enter your Second Student’s Name, Student ID Number, Date of Birth, Age and Grade.

Please type your first and last name: *

Please indicate your relationship to the student(s): *

MCPS Data and Security Information

https://www.montgomeryschoolsmd.org/data-privacy-security/

Online Digital Tools

If you choose not to provide consent for your student to use the above tools, alternative instructional activities will be provided. Please select one below. *

Here is the official document that you are filling out below.

https://drive.google.com/file/d/1GTaEVmwpfCoO8Ye3csZcsUDaXDW9905b/view?usp=sharing

I consent to this student’s participation in the Verizon Innovative Learning Project. As part of this Project, the student will receive, at no charge, a wireless device and service that have been donated by Verizon Wireless for the student’s use as long as the student is an active participant in the Project. I understand that student’s authorization to utilize the wireless device and service may be terminated at any time or for any reason by Verizon Wireless. *

I consent to the public use of this student’s photograph and video/audio recordings to promote the Verizon Innovative Learning Project in print publications, online publications, presentations, websites, and/or social media without any royalty, fee, or other compensation payable to me or this student as a result of such use. If students or parents of students have opted out then these students’ likenesses and voices may not be used in any photographic or audio storytelling done as part of the Verizon Innovative Learning Project. *

I understand that this student will receive a device, along with access to the internet, for academic purposes only. Usage for non-educational purposes is prohibited. Selling or transferring a device to any third party or allowing any third party to use wireless service for purposes other than related to the program is prohibited. *

I understand that this student will comply with MCPS Regulations IGT-RA, User Responsibility for Computer Systems, Electronic Information, and Network Security and COG-RA, Personal Mobile Devices. *

I understand that MCPS may collect data and monitor the student use of the device(s) and service(s), with appropriate notice and consent. *

I understand that MCPS has sole discretion to notify Verizon to terminate service if student violates MCPS Regulation IGT-RA in any way. *

I understand that I need to monitor my data usage so that it does not exceed 5 GB per month and that I may not stream audio or video except in connection with the program, and that I may not stream games. *

I agree not to download any billable or paid applications (apps) except those that are provided by my school. *

I agree not to use the personal hotspot on the device or allow any other devices to access the device’s personal hotspot. *

I agree not to remove any hardware (i.e. SIM chip) or software from the device unless authorized by Verizon. *

I agree to use my assigned device only within the 50 states of the United States of America. This includes not making international calls or sending international text, video or picture messages, including calls and messages to Canada and Mexico. *

If my assigned wireless device is lost or stolen, I agree to report it immediately to the school principal or district lead who will then notify Digital Promise. *

I understand that the student is bound by and agrees to the privacy statement posted at www.verizonwireless.com/privacy, as reasonably amended from time to time by Verizon. Any changes to the privacy statement, posted at www.verizonwireless.com/privacy, on the Effective Date of this Agreement, that are inconsistent with this Agreement or materially alter the obligations of the Parties under this Agreement shall not apply to MCPS or students, without MCPS’ express written consent. *

I agree to be kind and safe in my digital interactions with others and to take care of the device assigned to me. *

I understand if I violate any of these terms, I may be required to return my assigned wireless device to the principal who will return it to the district lead. *

I understand that MCPS does not permit or authorize this student to purchase any additional data plans through participation in the Verizon Innovative Learning Project. *

I understand that my school will provide additional details and a separate consent form regarding the research component of the Verizon Innovative Learning Project, which is entirely voluntary, and affirmative parent/guardian consent is required for MCPS to provide any student-level data as part of the Verizon Innovative Learning Project to Verizon Wireless, Digital Promise, or any third party for the research component of the study. *

I have read, understand, and agree to the Verizon Wireless terms and conditions appended to this consent form as Exhibit A (attached (Links to an external site.)), and further understand that Verizon may review this signed consent form at any time. *

I certify that all information provided on this form is accurate and that I have the authority to provide this consent. *

Dear Parent/Guardian,

Your child’s school is participating in the Verizon Innovative Learning Schools (VILS) initiative. As part of this initiative, the Verizon Foundation has contracted with Westat to conduct a multi-year study of the program’s impact on teachers and students. A primary goal of this study is to measure the effect of providing middle school students with mobile technology and 24/7 Internet access.
As part of the program your child will be participating in some important data collection activities.
Online Survey: Your child will complete a short survey about his/her use of learning technologies and interest in academic subjects. This survey will be administered during the school day at four points in time: fall of 2021, spring of 2022, spring of 2023, and spring of 2024.
Focus Groups: Your child may also be asked to participate in a focus group in the spring of 2022, where we will discuss the use of tablets. The focus group will be audio recorded to ensure accurate notes. The recording will be deleted at the end of the year.
Classroom Observation: Westat will be observing teaching practices in a sample of classrooms. The purpose is to see how the iPads are being used as part of the instructional process. No data will be collected about individual students who are part of this observation.
Also as part of the study, MCPS will provide de-identified information about your child’s attendance, disciplinary actions, end of year grades, and scores on standardized tests for the 2019-20, 2020-21, 2021-22 school years as well as the previous two years.
Information gathered for this study will only be used for research purposes. Your child is not required to participate in this study. These activities are completely voluntary and he/she may stop at any time. No individual information about your child or about your child’s classroom will be reported or shared. All information will be kept confidential and your child’s participation will not affect your child’s grades.
If you have questions about the implementation or MCPS’ involvement, or your child’s rights as a participant, you may contact Dr. Kara Trenkamp, director, Department of Technology Integration and Learning Management Systems.
Please complete and submit below indicating agreement to allow your child to participate in the VILS Initiative study.

Please select ONE option below: *

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