Home Welcome To Assessments AZELLA Additional Accommodations Request FY2027 AZELLA Additional Accommodations Request FY2027 Introduction This is a request for additional accommodations for one (1) student who is eligible for the administration of Arizona's English Language Learner Assessment (AZELLA) and has a current IEP or 504 Plan. One request submission will cover both test administrations, the Placement (Dynamic Screener) and the Spring Reassessment Summative. 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. Do NOT Submit This Form If: The accommodation requested is a Universal Test Administration Condition (available to any student). The student qualifies for the Alternate ELPA (Alt ELPA). The student scored Proficient on the most recent ELP test (see student's EL70 Report). Universal Test Administration Conditions supports are available to any student and do not require approval. Do NOT submit a request for accommodations for these. Examples include but are not limited to: Small group or separate setting Frequent breaks Pencil grip or adaptive furniture Clarifying or repeating scripted directions only English Language Proficiency assessment participation cannot be waived for eligible students There are no provisions, in either state or federal law, that would allow the exemption of English Language Proficiency testing for eligible students who are enrolled in the Special Education program and require an English language proficiency assessment. An IEP Team, which should include a second language acquisition specialist, may NOT exempt a student from participating in ELP testing. Use this form to request additional testing accommodations for the AZELLA that are not already allowed under Universal Test Administration Conditions. This request may be submitted only for students who: Are eligible for AZELLA because they are potential English learners or have an identified English language need, and Do not qualify for the Alt ELPA, and Require additional accommodations due to a documented disability or unique need. Only request accommodations that: Are routinely used by the student during instruction Are documented in an IEP, 504 Plan, or other formal plan Not all accommodations are appropriate for English language proficiency testing. Approvable accommodations are those that do not alter the construct that the assessment is intended to measure. "Alter the construct” means the accommodation reduces or replaces the student’s need to demonstrate English listening, speaking, reading, or writing skills. Examples include: Reading test questions or passages aloud Using text-to-speech for the extended writing portion of the test Translating test content into another language Simplifying or explaining test questions All additional accommodations requested on this form must also be documented in the student’s IEP or 504 Plan under accommodations for instruction, district assessments, and state assessments. Any accommodations specific to the English language proficiency test must be included in the IEP or 504 Plan. This request must include supporting documentation pages from the student’s IEP or 504 Plan. The submission of this request form does not constitute an approval for the additional accommodations being requested. ADE will review the request and then 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 entire review process may take up to 4 calendar weeks from the submission date, provided that all required documentation is included in the original request or additional information is submitted in a timely manner upon ADE's request. The student may NOT begin testing until ADE's response indicates to proceed with the administration of the test. Alt ELPA: When the student's IEP Team has determined the student is eligible for Alternate Assessments, then the student must be administered the Alt ELPA in lieu of the AZELLA. For students who are eligible for the Alt ELPA, this Additional Accommodations Request form is not necessary. Your Alternate Assessment DTC receives communications and guidance from ADE's Alternate Assessment Team regarding training and timelines for the administration of the Alt ELPA tests. If this request is ONLY for the single accommodation to administer the test in more than 5 instructional days, please DO NOT complete this request. Close this request form and go to the AZELLA Request to Administer the Test in More than 5 Instructional Days. This request can include multiple qualified students for one school. Date Enter today's date. Test Placement - Dynamic Screener Reassessment - Summative Check one or both for the current school year. SSID Grade - Select -KG123456789101112 Type - Select -IEP504 Plan District District Entity Number School School Entity Number DTC DTC Email Transfer Student Is this a student who has recently (this school year) transferred into your school? Yes No Transfer Student District and School Please identify the district and school where the student was recently enrolled prior to enrolling in your school. Do not use acronyms. Please use the entire district and school names and their entity numbers, if known. Access All Domains Can the student access all of the English language domains (Listening, Reading, Writing, and Speaking) WITH allowable and approvable accommodations? Yes No AZELLA Domains Speaking Listening Reading Writing CHECK NO MORE THAN THREE (3). Identify the English language domain(s) in which the student's disability precludes participation (cannot access a given domain due to a disability). There are no exemptions to being administered a full AZELLA. The entire test must be administered as prescribed by the Test Administration Directions. However, if a student is unable to access one or more of the domains even with accommodations 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 indicates that student is not able to access. A student may NOT be exempt from ALL FOUR (4) domains. Attest I attest that the student for whom I am submitting this request for additional accommodations experiences blindness or deafness that is permanent in nature and precludes access to one or more of the English language domains. I also attest that the need for additional accommodations submitted to and approved by the Arizona Department of Education has not changed since the initial request. Yes Not Applicable Additional Accommodations Additional Accommodations The selections below are based on the type of accommodated test form and grade or grade band. Special Paper Version (SPV) - None -KindergartenGrade 1Grades 2-3Grades 4-5Grades 6-8Grades 9-12 Special Paper Version - Large Print (SPV-LP) - None -KindergartenGrade 1Grades 2-3Grades 4-5Grades 6-8Grades 9-12 American Sign Language (ASL) - None -KindergartenGrade 1Grades 2-3Grades 4-5Grades 6-8Grades 9-12 Braille - None -KindergartenGrade 1Grades 2-3Grades 4-5Grades 6-8Grades 9-12 Domain Access Listening exception Speaking exception Reading exception Writing exception Testing in More than Five (5) Days Allow the test to be administered in over more than 5 days - one other additional accommodation must be selected. Other Accommodation Other. Use the box below to enter this information. Please be specific and provide as much detail as possible. Other Accommodations Student Assistive Technologies Does the student use assistive technologies? Yes No Name, Type, and Task for Each Device Enter the official names, type (Switch, AAC, Mobility, etc.), and the primary task that the device supports for the devices that are included in the student's IEP or 504 Plan, and that the student routinely uses during instruction and assessment. What is the level of independence with device(s)? Describe how the student controls each device (e.g., eye gaze, voice input, pressing a button, etc.) Do any of the devices have Internet access? If so, can the Internet be disabled on those devices? EL Needs Addressing EL NeedsPlease 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. Explaining EL Needs Submitter's Name Email File Uploads File Uploads Not all accommodations are appropriate for English language proficiency 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. The Grades K-12 ELP State Test, AZELLA, must be identified in the State Assessment section of the IEP/504 Plan. These pages must have the student’s SSID number, demographics, and the date of the document on each page submitted. Do not submit the entire IEP or 504 Plan. The following 2 sections must be included with this submission: PLAAFP (Present Levels of Academic Achievement and Functional Performance) Instructional and Assessment Accommodations THIS IS A SECURE FILE SUBMISSION. Allowed file extensions – .pdf., .doc, .docx, .xls, and .xlsx Do NOT use the 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. File #1 Upload One file only.100 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. File #2 (if needed) Upload One file only.100 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. File #3 (if needed) Upload One file only.100 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. File #4 (if needed) Upload One file only.100 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. I Consent NOTICE: This report (and any attachments) contains 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 to the Arizona Department of Education that this student requires additional AZELLA testing accommodations per the student’s IEP or 504 Plan for the current school year. I understand that the information I have provided may be shared with my District Superintendent/Charter Holder, School Principal, EL Coordinator, AZELLA District Test Coordinator, and other ADE units as necessary. Yes, I confirm and consent to the honesty of my AZELLA Additional Accommodations Request for a student that has a current IEP or 504 Plan as submitted to the Arizona Department of Education, Assessments Division. SUBMIT TO ADE Leave this field blank