Missouri School Counselor Performance Assessment (MoSCPA) Pilot Submission Terms  I agree to comply with the terms of the Missouri School Counselor Performance Assessment (MoSCPA) Candidate Handbook;  I understand that I am submitting my own responses and artifacts associated with this task, and I agree not to share any of my responses and artifacts with future test-takers;  I understand the role of professional ethics and that my ability to earn a Missouri School Counselor Certificate will be jeopardized if I violate the privacy of my students and/or coworkers by posting any responses, artifacts, and videos without appropriate permission from students, parents, and co-workers;  I certify that the submission represents the work that I completed and that I have submitted to ETS all signed Student and Adult Release forms required by the assessment;  I understand that the responses, artifacts, and video that I submit will be evaluated by educators, raters, or other appropriate individuals, and I understand that I will not be able to make any modifications once I submit my task responses;  I certify that I am the counselor candidate depicted in the video, and I further give permission for all parts of my submission (including the video and audio recording of my image and interactions) to be used by the Missouri Department of Elementary and Secondary Education (DESE) and ETS for the development of exemplars, research relating to the improvement of the assessment, establishing effective state policy or other appropriate and necessary official state business;  I understand and agree that I will not obtain any ownership or other intellectual property rights in any information or materials posted on, or linked from this website, including the assessment tasks, the rubrics, and all support materials which are owned by the Missouri Department of Elementary and Secondary Education (DESE) and ETS, as applicable. Signature ______________________________________________ Date _____________________ © 2015 MoDESE. The Department of Elementary and Secondary Education does not discriminate on the basis of race, color, religion, gender, national origin, age, or disability in its programs and activities. Inquiries related to Department programs and to the location of services, activities, and facilities that are accessible by persons with disabilities may be directed to the Jefferson State Office Building, Office of the General Counsel, Coordinator – Civil Rights Compliance (Title VI/Title IX/504/ADA/Age Act), 6th Floor, 205 Jefferson Street, P.O. Box 480, Jefferson City, MO 65102-0480; telephone number 573-526-4757 or TTY 800-735-2966; email [email protected]