Get Nmped Test Irregularity Form

New Mexico Public Education Department Testing Irregularity Reporting Form A testing irregularity occurs when state test materials are not stored handled or disposed of in a secure manner or when required test preparation and administration procedures are not strictly followed as specified in Section 6. 10. 7. 9 of New Mexico Administrative Code NMAC. School personnel or volunteers must promptly report testing irregularities to the District Test Coordinator DTC and to the Public Education Department PED 6. 10. 7. 9 of New Mexico Administrative Code NMAC. School personnel or volunteers must promptly report testing irregularities to the District Test Coordinator DTC and to the Public Education Department PED 6. 10. 7. 12 NMAC. This form should be completed by school district personnel and submitted to the Principal DTC and the PED s Assessment and Evaluation Bureau fax 505. 827. 6689 within three 3 days of learning of the incident. Attach additional pages as necessary. Person Reporting Position/Role Phone Number Email Address District Code District Name School Code School Name Date Principal Name District Test Coordinator Dates DTC Trained School Test Coordinator Test Administrator Proctor Dates Proctor Trained If applicable Date of Incident Page 1 of 2 January 2013 Time of Incident Content Area and Sessions Involved Grade Level of Students Involved SBA Access for ELLs NMAPA NMHSCE Description of Testing Irregularity Write a brief description below and attach detailed written documentation from all involved individuals. New Mexico Public Education Department Testing Irregularity Reporting Form A testing irregularity occurs when state test materials are not stored handled or disposed of in a secure manner or when required test preparation and administration procedures are not strictly followed as specified in Section 6. 10. 7. 9 of New Mexico Administrative Code NMAC. School personnel or volunteers must promptly report testing irregularities to the District Test Coordinator DTC and to the Public Education Department PED 6. 10. 7. 12 NMAC. This form should be completed by school district personnel and submitted to the Principal DTC and the PED s Assessment and Evaluation Bureau fax 505. 827. 6689 within three 3 days of learning of the incident. Attach additional pages as necessary. Person Reporting Position/Role Phone Number Email Address District Code District Name School Code School Name Date Principal Name District Test Coordinator Dates DTC Trained School Test Coordinator Test Administrator Proctor Dates Proctor Trained If applicable Date of Incident Page 1 of 2 January 2013 Time of Incident Content Area and Sessions Involved Grade Level of Students Involved SBA Access for ELLs NMAPA NMHSCE Description of Testing Irregularity Write a brief description below and attach detailed written documentation from all involved individuals. In this section please refer to individuals only by position or title not by name. If test s are invalidated list student s State Student ID Number first name last name date of birth grade level and SBA content area Use a spreadsheet if necessary District Recommendation Indicate if invalidation of results is recommended* The level of seriousness the district assigns to this incident and if the district will impose sanctions on students or staff* Note please refer to individuals only by position or title.