AZELLA Special Paper Version (SPV) and Large Print (LP) Request Form

* required field

This request form is restricted to EL/SPED students with a current IEP or 504 Plan or currently incarcerated students. This request is for a Special Paper Version (SPV) or large print (LP) version of the 2020-2021 AZELLA Placement Test, the Spring 2021 Reassessment Test, and the 2021 Stand-Alone Filed Test. This request must include specific documentation pages from the student’s IEP or 504 Plan. The requested accommodation should be used routinely during regular instruction throughout the year and identified as an "AZELLA" state test accommodation. The Special Paper Version (SPV) of an online AZELLA test is only available for online testing students who cannot use and access technology devices for regular classroom instruction and state assessments due to disabilities.  Large Print (LP) test materials are available for Grades K-1 (all AZELLA tests), Grade 2 (Placement and Reassessment) and Grade 2 SPV (2021 Stand-Alone Field Test), and Grades 3-12 all SPV tests for students with a current IEP/504 Plan that indicates the student uses large print regular classroom materials and need large print state testing materials. The online testing students are able to enlarge the online test by using the Zoom feature in TestNav, or the student can be administered the online test in a 1-on-1 test administration so that the test can be enlarged on a screen or wall. Students who enlarge the online test would not need a large print Special Paper Version. This request form is also required for online AZELLA testing students who are incarcerated and not permitted to use technology. A document must be uploaded with this request indicating the school where the student is currently located and a statement stating that students are not permitted to use technology for state assessments.  A separate form must be submitted for each student.
District Test Coordinator (DTC) Name
Person Submitting Form
Name of Person Submitting Form (if other than DTC)
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 School name.
Do not use the school's CTDS number. It must be the school Entity number. School Entity Number 9 max characters
Student Information
THIS IS A SECURE APPLICATION AND FILE SUBMISSION SITE
Please use the zero - "0" for Kindergarten students.
Please Note: Braille is NOT available for AZELLA. Check one (1) option. The Special Paper Version (SPV) is strictly for those online AZELLA tests when students CANNOT use and access technology for regular daily instruction and assessments. The Large Print (LP) is for students who require an enlarged print in paper form. This is strictly for Grades K and 1 all AZELLA tests, Grade 2 Placement and Reassessment and Grade 2 SPV for the Stand-Alone Field Test, and Grades 3-12 SPV of all AZELLA tests.
The Special Paper Version (SPV) is strictly for students assigned to an online AZELLA test in Grade 2 for the 2021 Stand-Alone Field Test, and Grades 3-12 all AZELLA tests. Students must have a current IEP, 504 Plan, or residing in a detention center or prison. These students CANNOT use and access technology for regular daily instruction and assessments.
Paper large print (LP) testing materials are available for those students with a current IEP/504 Plan that includes large print materials for regular classroom instruction and assessments. The large print for online students is associated with the Special Paper Version for students who CANNOT use and access technology. For students assigned to an online AZELLA test, TestNav has the ability to enlarge the test on the student's screen as well as the student may be administered the online test in a 1-on-1 test environment where the online test can be projected onto a screen or wall thus enlarging it for the student.
You must submit page(s) of the ACTUAL sections of the student’s official IEP or 504 plan that indicate the needed accommodations are used routinely during instruction and assessments throughout the year. These pages must have the student’s demographics or SSID and the date of the document on each page submitted. Do not submit the entire IEP or 504 Plan. This request form is also required for students who are incarcerated and not permitted to use technology. A document must be uploaded with this request indicating the school where the student is currently located and a statement stating that students are not permitted to use technology for state assessments. A separate request form must be submitted for each student. THIS IS A SECURE FILE SUBMISSION. Allowed file extensions – .pdf.,doc,.docx,.xls,.jpg,.gif,.png, or .tiff
Comments
I confirm that I have submitted documentation to ADE that this student requires a Special Paper Version Test for the state assessment(s).