Testing Irregularity Report

Testing Irregularity Report

A testing irregularity refers to any deviation from standardized conditions during testing (e.g., sudden illness, school emergencies) and must be documented with the Indiana Department of Education (IDOE). Complete this form to report a testing irregularity to IDOE's Office of Student Assessment. Refer to the Indiana Assessments Policy Manual for additional information.

Select the testing window in which the irregularity occurred. Note: Testing irregularities for the Digital SAT School Day must be reported via College Board's Irregularity Report.

Date of Incident

Date

Corporation Name:

Corporation Number:

School Name:

School Number:

Staff Member Submitting Form:

First NameLast Name

Title

Phone Number

Format: (000) 000-0000.

Email:

Confirmation Emailexample@example.com

Corporation Test Coordinator:

First NameLast Name

Corporation Test Coordinator Phone Number:

Format: (000) 000-0000.

Corporation Test Coordinator Email:

Confirmation Emailexample@example.com

Type of Incident

Describe what took place in as much detail as possible, including the steps taken by the school/corporation upon learning about the situation. Please do not include personally-identifiable student information.

Indicate the number of students affected:

Indicate the number of classrooms affected:

STNs:

Optional: STN File Upload

Session ID (if applicable):

Test Name (e.g., IREAD-3 Segment 1):

Testing Mode

Have any tests been invalidated?

Number of tests invalidated:

Awaiting IDOE response?

Add supporting documentation, as needed: