2025-2026 Test Administration Considerations Request Form

Created for Tricia Stephens by Nhan Nguyen on 08/26/2021

2025-2026 Test Administration Considerations Request Form

Per page 19 of the Indiana Assessments Policy Manual and as relayed to schools by the Office of Accreditation and the Office of Choice Schools, it is the expectation that all statewide assessments will be delivered only by TAs who hold a current license granted by IDOE (see the list of acceptable licensure on page 19 of the Indiana Assessments Policy Manual).

IDOE consequences for test security and integrity violations for individuals who do not hold a valid license are limited, therefore schools requesting to use non-licensed staff for statewide assessments must present a thorough explanation regarding their limited amount of licensed staff, as well as a plan for training and monitoring unlicensed staff and consequences for staff found to have violated test security and integrity.

Corporation Number

Corporation Name

CTC Name

First NameLast Name

CTC Email Address

Confirmation Emailexample@example.com

CTC Phone Number

Format: (000) 000-0000.

1. Assessment Program for which consideration is requested.

2. How many schools are impacted by the proposed plan?

3. Which grade level(s) are impacted by the proposed plan?

4. What mode of instruction is offered by the impacted school(s)?

Other

5. Describe the proposed plan. This MUST include a description of any unique set-up, practices or protocols that differ from the examples and scenarios provided in IDOE’s guidance.

6. Describe how the corporation will ensure test security requirements are still met if the proposed plan is approved. Also, if the corporation is seeking flexibility regarding Test Administrator licensing requirements, describe local level consequences for non-certified staff found in violation of test security protocols.

7. Describe how the corporation will ensure the fidelity of the test administration and ensure that valid and reliable testing data is an ensured outcome if the proposed plan is approved

8. Describe how the corporation will ensure that staff appropriately provide students with accommodations included in their IEPs, ILPs, Section 504 Plans, CSEPs, or Service Plans if the proposed plan is approved

9. Confirm which internal stakeholders were involved in the creation of the proposed plan including test administrators, impacted building administrators or Central Office staff.

Our school has number* teachers/staff in our employ. Of that numbernumber* teachers/staff hold a valid license granted by IDOE.