* required field
This is a request to change an AZELLA (ELP) record that has reported out on the EL70 Report.
When the request is due to a student with multiple SSID numbers, a formal merge of SSIDs request must have been submitted to School Finance prior to submitting this request. When the request is due to a student sharing an SSID with another student, a formal split of SSID request must have been submitted to ADE's School Finance prior to submitting this request. You will need the School Finance ticket number to complete this request form.
This is a secure submission that contains student identifiable information; therefore, the submission confirmation email will not include all of the information required in this request.
STUDENT INFORMATION
TEST RECORD INFORMATION
CHANGE REQUEST INFORMATION