All students participating in our 2014 We Are Silent event must return this completed form to Ms. Wray in advance.

1. Some ESA students will be participating in We Are Silent on Thursday April 17th,
which happens to be a Day One on the schedule.
Participating students will be pledging to remain silent for 24 hours... taking “a
silent stand for everyone who is being bullied, exploited or denied their rights.”
Students understand that participation does not excuse them from any classroom
obligations which demand their participation (i.e. in-class debates, or
presentations, etc.).
If you are being presented with this form...
Thank you for taking a moment to sign off that you understand why the said
student will be silent in your class that day.
Please also indicate, if you know already, whether or not there is any reason why
the student will need to contribute to the class on April 17th, or whether you
expect that they will be able to maintain their vow of silence.
Students understand that timing may change, and it could be that they will be
required to speak during class on the day when it arrives.
Your understanding of the importance of student participation in this event is
greatly appreciated.
Thanks...
Day One Teachers... Please sign off. ! Thanks

2. Student Name:! _____________________
PER
Teacher
(Please print your
name and initial...
Thanks)
I foresee no reason
why the above named
student can’t remain
silent in class on
April 17th
The student has the
following obligations in
class on April 17th
which will require
communication
1
2
3
4
Day One Teachers... Please sign off. ! Thanks
All participating students must return this form to Ms. Wray by no later
than the end of the school day on Monday April 14th.
Failure to do so means that you will not be included on the “official list”
of participating students which we will send to all Staff in advance of
April 17th.