Student Assessment Experience Recording Consent Form
Please complete this form to share your assessment details, recording preferences, experience feedback, and consent for recording your assessment experience.
Student Details
Student Full Name
*
First Name
Last Name
Student ID
*
Email Address
*
example@example.com
Class / Course / Section
*
Assessment and Recording Details
Assessment Name or Topic
*
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessment Format or Mode
*
Written
Oral
Practical
Presentation
Other
Recording Type or Medium
*
Audio
Video
Audio and Video
Screen Recording
Other
Experience and Consent
How comfortable are you with being recorded during the assessment experience?
*
Very uncomfortable
1
2
3
4
5
6
7
8
9
Very comfortable
10
1 is Very uncomfortable, 10 is Very comfortable
Brief experience feedback
*
Rows
1
2
3
4
5
Clarity
1
2
3
4
5
Fairness
6
7
8
9
10
Distraction level
11
12
13
14
15
Do you agree to have your assessment experience recorded for instructional and review purposes?
*
Yes, I agree
No, I do not agree
Submit Form
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