Achievement Testing Additional Accommodations Request FY23

* required field

This is a request for additional Achievement testing accommodations for a student with a current IEP or 504 Plan.

  • The additional accommodations requested SHOULD NOT include Universal Test Administration Conditions, Universal Tools, or other accommodations identified as allowable in the Achievement Assessments Accommodations Manual, located on ADE's Assessment Accessibility web page at https://www.azed.gov/assessment/accessibility.
  • This form should be used to request the American Sign Language (ASL) form of the test, assistive technology needed by the student during testing, or testing accommodations requested due to a student injury as described in the Achievement Assessments Accommodations Manual.

One request submission will cover the following Achievement assessments for the student during the current school year: AASA (Grades 3-8), AzSCI (Grades 5, 8, and 11/Cohort 2024), and/or ACT Aspire (Grade 9/Cohort 2026). This submission form MAY NOT be used for any accommodations requests for ACT. All ACT requests must be submitted through ACT's Test Accessibility and Accommodations (TAA) system.

This request is only valid for the current school year. If instructional and assessment accommodations in the student’s IEP or 504 Plan are updated during the current school year after this initial submission, you will need to submit a new request.

For students needing a Special Paper Version (Braille, Large Print, or regular print) test, please submit the Special Paper Version (SPV) Request form for Spring 2022: https://www.azed.gov/assessment/spv2022.  

Not all accommodations are appropriate for statewide Achievement testing. Accommodations MAY NOT ALTER the construct of the assessment.

The additional accommodations being requested in this form must be included in the instructional accommodations section of the IEP or 504 Plan as well as in the assessment accommodations for statewide assessments. This request must include specific and detailed information and documentation pages extracted from the student’s IEP or 504 Plan that pertain to the requested accommodations routinely used for instruction and assessment.

The submission of this request form does not constitute an approval for the additional accommodations requested. ADE will review the request and then ADE will provide a response to the Achievement District Test Coordinator that includes approval, partial approval, denial, or a request for additional information for each accommodation being requested.

District Test Coordinator (DTC) Name
Person Submitting Form
District and School
Enter the correct and full District/Charter District name.
Do not use the district/charter's CTDS number. It must be the Entity number. District/Charter Entity Number 9 max characters
Enter the correct and full name of the School.
Do not use the school's CTDS number. It must be the school Entity number. School Entity Number 9 max characters
School uses Computer-Based Testing or Paper-Based Testing.
Student Information
THIS IS A SECURE APPLICATION AND FILE SUBMISSION SITE
If the student has recently transferred into the district, please enter the date of the transfer. If the student has recently qualified for this accommodation or has had a change to their IEP or 504 plan, please enter the date of this change.
Any accommodations requests for ACT (Grade 11) are to be submitted directly to ACT using ACT’s processes and are not to be submitted to ADE for approval. ACT’s Test Accessibility and Accommodations (TAA) system is open for initial accommodations requests through January 27, 2023.
Additional Accommodations
Not all accommodations are appropriate for statewide Achievement testing. Accommodations may not alter the construct of the assessment. The additional accommodations being requested SHOULD NOT include those listed under the Universal Test Administration Conditions and under the Universal Tools. See the Achievement Assessments Accommodations Manual on ADE's Assessment Accessibility web page at https://www.azed.gov/assessment/accessibility. Decisions on accommodations requests are based on the information provided in the IEP or 504 Plan. Please provide additional information that may not be captured in the IEP or 504 Plan that will support the review of this request.
Does this additional accommodations request include the use of American Sign Language (ASL)?
Does this additional accommodations request include the use of Assistive Technology?
Assistive Technology Additional Information
COMPLETE THIS SECTION IF "YES" WAS SELECTED FOR ASSISTIVE TECHNOLOGY
Please provide an example.
Is this accommodations request being submitted due to a student injury? Please note that a doctor's written recommendation will be required with the submission.

For a student with an IEP or 504 Plan, please submit the following sections of the documentation:

  • Present Levels of Academic Achievement and Functional Performance
  • Instructional Accommodations
  • Assessment Accommodations 

 

For a student with an injury, please submit the doctor's written recommendation for the student.

THIS IS A SECURE FILE SUBMISSION.

Allowed file extensions – .pdf, .doc, .docx, .jpg, .png, .xls, or .xlsx

I confirm that I have submitted documentation to ADE that this student requires additional testing accommodations per the student’s IEP, 504 Plan, and/or doctor's written recommendation for the current school year.