Achievement Testing Additional Accommodations Request 2024-2025

* required field

This request form is for additional Achievement Assessment accommodations for a student with a current IEP or 504 Plan. This form is to be used for AASA, AzSCI, and ACT Aspire requests, including:

  • AASA or AzSCI American Sign Language (ASL) test form
  • ACT Aspire American Sign Language (ASL): Full Translation (requires a paper test to be administered during the shorter ACT Aspire paper-based testing window)
    • A request does not need to be submitted for ACT Aspire ASL: Directions Only
  • AASA, AzSCI, or ACT Aspire computer-based test in a paper-based testing school
  • AASA, AzSCI, or ACT Aspire hearing devices requiring a Bluetooth connection
  • AASA, AzSCI, or ACT Aspire accommodations required due to a student injury, medical condition, or visual impairment as described in the Achievement Assessments Accommodations Manual
  • Additional accommodations or assistive technology needed by a student during testing that are not included in the Achievement Assessments Accommodations Manual
  • ACT Aspire Speech-to-Text (requires a 1:1 test administration; requires a paper test to be administered during the shorter ACT Aspire paper-based testing window)
    • Speech-to-Text is not permitted on AASA or AzSCI tests.

This form should not be used to request a braille, large print, or regular print paper test. Instead, the Special Paper Version test request form should be used for any paper testing requests.

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.

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.

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 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
District/Charter Entity Number (maximum 9 characters)
School Entity Number (maximum 9 characters)
Indicate if the 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.
Does this additional accommodations request include the use of American Sign Language (ASL)?
Does this additional accommodations request include use of hearing devices that require a Bluetooth connection?
Does this additional accommodations request include a computer-based test in a paper-based testing school?
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.
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.

You must submit pages of the student's current IEP or 504 plan that indicate a need for the additional accommodations. The document you submit must include:

  • The date of the document and the student's first and last name and SSID.

  • The Present Levels of Academic Achievement and Functional Performance (PLAAFP).

  • The Instructional Accommodations section of the document that includes accommodations used routinely during instruction throughout the year. The instructional accommodations must align with the assessment accommodations.

  • The Assessment Accommodations section of the document that lists the student's testing accommodations for district and state assessments.

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.