AZELLA Test Administration Irregularity Report 2022-2023

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This AZELLA Test Administration Irregularity Report is used to report AZELLA TEST ADMINISTRATION incidents that have affected a student or group of students’ tests. AZELLA test administration irregularities should be reported to the Arizona Department of Education's AZELLA Team within 24 hours of the incident. This report is a secure online form. ADE's AZELLA Team will respond within 2 full business days after receiving the submitted report.

This form should not be used when there is a student-caused irregularity. You must submit all K-12 student-caused incidents (e.g., technology issues) through PearsonAccess Next.

The Lithocode Exchange Form should be completed and emailed to [email protected] when the student assigned Lithocodes were not used with the correct students. Also, for incidents associated with the telephone Speaking tests regarding an interruption or an aborted call, the AZELLA DTC must submit a request for a new Lithocode through PAN under Support >> Support Requests.

This is not a form for reporting test security and ethics incidents. Please use the AZELLA Test Security and Ethics Incident Report. 

Enter today's date.
Enter the 10-digit phone number to reach you should ADE's AZELLA Team have questions about this report.
Enter the full names (first and last), separated by commas, of other adults involved or who witnessed this incident.
Please enter the SSID number, grade level, and the assigned Speaking test Lithocode for all students. (Lithocodes are not associated with the KPT and online tests)
Identify the test irregularities involved in this incident. You must check at least one box. Check all that apply.
Provide a full detailed narrative of this incident.

You may attach and submit additional information as necessary.

THIS IS A SECURE FILE SUBMISSION.

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

Do NOT use the smaller blue "Upload" buttons on the right side of the screen. They do NOT work. Use the "Choose File" to add your file(s) to the request. The file(s) will be sent to ADE after the request is submitted.

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 administration 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.