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  • AZELLA Test Security and Ethics Incident Report

AZELLA Test Security and Ethics Incident Report

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This AZELLA Test Security and Ethics Incident Report is used to report AZELLA test security and ethics violations for Grades K-12 AZELLA Placement Tests, the annual Spring Reassessment Test, and the 2021 Stand-Alone Field Test. All AZELLA test security and ethics violations must be reported to the Arizona Department of Education's AZELLA Team within 24 hours of the incident. This report is a secure online form.
Person Submitting Form
Name of Person Submitting Form (if other than DTC)
District or Charter Holder and Entity ID
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
AZELLA District Test Coordinator (DTC)
AZELLA School Test Coordinator
AZELLA Test Administrator
Enter the first and last names of adults other than the District and School Test Coordinator and the Test Administrator that were involved in or witnessed this incident
For all students involved in this report, please enter their SSIDs and Grade Levels on separate lines. SSID xxxxxxxx; Grade X
Identify the test security and ethics violations involved in this incident. Check all that apply.
Detailed Description of Incident
Enter a DETAILED description of the irregularity that is being reported.
You may attach and submit additional information as necessary. THIS IS A SECURE FILE SUBMISSION. Allowed file extensions – .pdf.,doc,.docx,.xls,.jpg,.gif,.png, or .tiff
Consent
NOTICE: This report (and any attachments) may contain PRIVILEGED OR CONFIDENTIAL information under state and federal law. This information may be used or disclosed only in accordance with law.
I confirm that I have submitted truthful information and documentation about an AZELLA Test irregularity to the Arizona Department of Education. I understand that the information I have provided may be shared with the District Superintendent/Charter Holder, School Principal, EL Coordinator, AZELLA District Test Coordinator, Pearson, and other ADE units as well as other State and Federal agencies as necessary.
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