OFF-SITE TEST ADMINISTRATION REQUEST Spring 2018
This form is used to request permission for the off-site administration of MDE assessments.
Contact Email Address
Please indicate if the school is testing primarily online or with paper and pencil.
Paper and Pencil
Briefly explain why an Off-Site Test Administration is necessary.
Does the request apply to the Seat Time Waiver Program or Other Program? Please Explain.
Provide the address and a brief description of the facility proposed for off-site testing. (Examples include: central office building, community college, community center, YMCA, etc.)
Describe the off-site location in terms of safety, testing environment and how test security will be maintained.
Which grades will be tested at the off-site location? Check All That Apply
Which test(s) will be administered at the off-site location? Select all that apply.
Early Literacy & Mathematics
Which MI-Access Assessment(s)?
Which WIDA Assessment(s)?
WIDA ACCESS for ELLs 2.0
WIDA Alternate ACCESS for ELLs
Which group(s) of students will receive accommodations at the off-site location? Check all that apply.
General Education Students
Students with IEPs
Students with 504 Plans
Describe the plan for providing designated supports and accommodations to students at the off-site location.
If testing online at the off-site location, provide information on how you will ensure the site has adequate local device connectivity (i.e. dedicated or shared Wi-Fi Access Point, wired network connection, Wi-Fi hotspot, etc.) and internet bandwidth capacity. Describe the testing hardware that will be used with the Testing Site Manager (TSM) and anticipated number of simultaneous test sessions. Please refer to the Technology User Guide for additional information. The Technology User Guide can be found under All Applications – General Information - Documents at https://mi.drcedirect.com/
Provide the name, title, and phone number of the person who will supervise the off-site testing.
Provide the name(s) and titles of the qualified test administrators and proctors who will provide testing at the off-site location. Please note that the Assessment Integrity Guide lists qualifications for test administrators and proctors.
If the off-site request is to allow for testing of a home-bound student, please provide the dates and estimated times that the tests will be administered.
For schools testing in multiple offsite locations, please attach a file that includes:
Name and Address of Offsite Location, Name of Qualified Test Administrator(s) administering assessments, Grade(s) and Content Area(s) tested, and Technology Requirements for each site, including ensuring adequate connectivity and testing hardware used for connecting to TSM.
Do Not Fill This Out