Consent Form for Collection of Writing Samples for Developing Writing Levels and Placement

The Office of International Education (OIE)

http://language.seoultech.ac.kr

Consent Form for Collection of Writing Samples
for Developing Writing Levels and Placement
어학교육연구원의 학생 글쓰기 샘플 사용에 대한 동의서

I understand that writing sample submission for SeoulTech Office of International Education (OIE) is voluntary. 내가 작성한 글을 어학교육연구원에 샘플로 제공하는 일이 자발적임을 확인합니다.	☐ Acknowledge (확인함)
I understand that my written responses will NOT be used or shared outside of SeoulTech Office of International Education (OIE). 내가 작성한 글이 어학교육연구원 이외 다른 곳에서 사용되지 않음을 확인합니다.	☐ Acknowledge (확인함)
I understand that my agreement or rejection to participate in the sample submission has no bearing on my grades at SeoulTech. 글쓰기 샘플 수집에 대한 나의 참여 또는 거절이 서울과학기술대학교 교과목 성적에 영향을 주지 않음을 확인합니다.	☐ Acknowledge (확인함)
I agree to submit my writing sample. 내가 작성한 글을 샘플로 사용하는데 동의합니다.	☐ Agree(동의함) ☐ Do not agree (동의하지 않음)
I will allow the OIE to use my written response to share among OIE faculty and administration for the purpose of developing writing levels and placement. 내가 작성한 글쓰기 응답내용을 어학교육연구원과 교수진이 영어글쓰기레벨 개발을 위해 사용하는데 동의합니다.	☐ Agree(동의함) ☐ Do not agree (동의하지 않음)

Name_____________________________ Student #_________________________

Signed____________________________ Date_____________________________

For Administrative Purposes Samples must be labeled with the student ID number(s) as well as other identifying information. A scanned version of this consent form must be added to the 3500 folder in the Drive with the same title + consent. e.g. 20F_PERW_exam1_19123456_16654321/20F_PERW_exam1_examconsentform_19123456
Professor’s name	Signed
	Date
Writing Sample Title