Confidential Pilot Testing · School Name: School Division: 1. Are you interested in participating in pilot testing this semester? Yes(If Yes, please provide details below.)

School Name:

School Division:

1. Are you interested in participating in pilot testing this semester? Yes (If Yes, please provide details below.) No (If No, please proceed to number 3.)

NOTE: An interest in participating does not guarantee that your school will be selected for the pilot test.

2. Below are the scheduled pilot test dates.

TESTS DATES

Grade 12 Applied Mathematics (3 hours1) Grade 12 Essential Mathematics (2 hours1)

Any day between June 3-6, 2019

1The length of time stated does not include preparation time.

Please provide the teacher’s name for each participating classroom in your school and complete your preferred dates and times for the pilot test administration, taking into account the dates listed above.

TESTS TEACHERS (include email address)

NO. OF STUDENTS

PROGRAM ENG., IMM., FR.

LANGUAGE OF TEST

ENG. OR FR.

PREFERRED DATES AND TIMES

Applied Mathematics

Mr. Raymond Martin [email protected] 22 IMM. FR.

June 5, 2019 8:30 a.m.

Mr. Mrs. Ms.

Mr. Mrs. Ms.

Mr. Mrs. Ms.

Mr. Mrs. Ms.

3. The principal’s signature is required whether interested in participating or not.

Name of principal Signature of principal Date (please print)

PLEASE RETURN THIS FORM BY APRIL 18, 2019, TO: Grade 12 Mathematics Pilot Tests

Instruction, Curriculum and Assessment Branch Fax: 204-948-3356 or 204-948-2442

Email: [email protected]

Confidential Pilot Testing

PILOT APPLICATION FORM (2018/2019)Grade 12 M athematics