[Street Address]

[Town, State  zip code]

(603)[ telephone number]

[Month, day, year]

[Name of Participating Agent]

[Title of Participating Agent]

[                                   School District]

[S.A.U. Number                       ]

[Street Address of Participating Agent]

[Town, State  zip code]

                                    RE:       [Student name]

Date of Birth [student date of birth]

[Academic Year] Home Education Assessment

Name of Test Administrator:

Address of Test Administrator:

Date Test Administered:

Dear [Dr./Mr./Ms. Name of Participating Agent]:

            Pursuant to RSA 193-A:6 and Ed 315.07, we enclose a copy of the home education testing result demonstrating educational progress by [student name] for the [              ] academic year.  Pursuant to Ed 315.08, please sign the enclosed duplicate of this letter and return it in the pre-addressed, postage-paid envelope provided to indicate your receipt of this testing result demonstrating educational progress.

            We do not authorize the release of any information contained in the enclosed except as specifically provided by law.  All information provided is privileged and confidential.  Any further disclosure requires written parental consent prior to such disclosure.

            Do not hesitate to contact us if you have any questions regarding the enclosed.


[Parent Name]