AZELLA Additional Accommodations Request FY22

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This is a request for additional accommodations for one (1) student eligible for the administration of the AZELLA and has a current IEP or 504 Plan. The additional accommodations being requested SHOULD NOT include those listed under the Universal Test Administration Conditions and under the "Approved AZELLA Assessment Accommodations." See ADE's Assessment Accessibility web page at https://www.azed.gov/assessment/accessibility.

One request submission will cover all AZELLA test administrations (Placement, Fall 2021 SAFT, and the Spring 2022 Reassessment) for the student during the current school year. This request is only valid for the current school year. If the student’s IEP or 504 Plan is updated for instruction and state assessments during the school year and after this initial submission, you will need to submit a new request with the updated IEP or 504 Plan.

For students only needing a Large Print (LP) version of the AZELLA, please submit the "AZELLA Large Print Paper Test Request Form" for students assigned to a paper type of AZELLA, or the "AZELLA Special Paper Version (SPV) Request Form" for students who are assigned to an online type of AZELLA test.

There are no provisions, in either state or federal law, that would allow the exemption of AZELLA testing for eligible students who are enrolled in the Special Education program and require an AZELLA test. An IEP Team, which must include an expert in second language acquisition, may NOT exempt a student from participating in AZELLA testing.

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

The additional accommodations being requested in this form must be included in the regular daily instruction section of the IEP or 504 Plan, as well as in the State Testing section and identified specifically for the "AZELLA" state test. Accommodations included in the IEP or 504 Plan for ELA, Math, Science, or just for "state testing" are not an indication for AZELLA. 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 AZELLA State testing.

The submission of this request form does not constitute an approval for the additional accommodations being requested. ADE will review the request and then ADE will provide a response to the AZELLA District Test Coordinator that includes approval, denial, or a request for additional information for each accommodation being requested. The student may NOT begin AZELLA testing until ADE's response indicates to proceed with the administration of the AZELLA test.

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
Student Information
THIS IS A SECURE APPLICATION AND FILE SUBMISSION SITE
Please use the zero - "0" for Kindergarten students.
Additional Accommodations
Not all accommodations are appropriate for AZELLA 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 "Approved AZELLA Assessment Accommodations." See ADE's Assessment Accessibility web page at https://www.azed.gov/assessment/accessibility.
Please Note: If this student is currently using braille in classroom instruction, please contact the AZELLA team after submitting this request form.
Identify the AZELLA Domain(s) in which the Student's Disability Precludes Participation (cannot access due to disability - e.g. completely deaf and completely blind and the student does not use any accommodations for the disability). Whenever administering any AZELLA test, the entire test must be administered. There are no exemptions to being administered a full AZELLA test. However, if, even with accommodations, a student is unable to ACCESS one or more of the AZELLA domains because the student has a disability that precludes his or her participation in that domain, you must identify the domain(s) that the student’s IEP or 504 Plan have indicated that student is not able to access. For example, a student who is completely deaf and/or completely blind may not be able to "access" specific AZELLA domains. A student with a speech disability can "access" the Speaking Test and must be provided an earnest attempt with the AZELLA Speaking Test unit. A student may NOT be exempt from ALL of the AZELLA domains.
Addressing EL Needs
Please provide documentation and information pertinent to the student's EL needs and how they are being addressed in daily instruction. You may include additional comments and information that is of value for the review of this request.
Not all accommodations are appropriate for AZELLA testing. Accommodations may not alter the construct of the assessment. Please provide documentation pertinent to the student’s EL needs and how they are being addressed in instruction. You must submit page(s) of the ACTUAL sections (not the entire IEP/504 Plan) of the student’s official IEP or 504 plan that indicate the needed accommodations are used routinely during instruction and assessments throughout the year. "AZELLA" State Test (Grades K-12) must be identified in the State Assessment section of the IEP/504 Plan. 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 IS A SECURE FILE SUBMISSION. Allowed file extensions – .pdf., .doc, .docx, .xls, and .xlsx
I confirm that I have submitted documentation to ADE that this student requires additional AZELLA testing accommodations per the student’s IEP or 504 Plan for the current school year.