Alt ELPA Screener Request (For each eligible student, submit one form per student)

Alternate Assessment DTC Name

Alternate Assessment DTC Email Address

SSID Number (8 digits)

Alternate Assessment Participation Guidelines and Annual Eligibility Determination Form

Alternate Assessment Participation Guidelines and Annual Eligibility Determination Form completely filled out.
One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.