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The ACT Consent Form for Request for Accommodations Students Name: School: Students Date of Birth: I wish to apply for testing accommodation(s) on The ACT due to disability. I authorize my school:.

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How to fill out the Act Accommodations Consent Form online

Filling out the Act Accommodations Consent Form online is a straightforward process designed to help students request necessary accommodations due to disabilities. This guide will provide step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the form online.

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. In the first section, enter the student's name, ensuring it matches their official documents.
  3. Fill in the school’s name where the student is currently enrolled.
  4. Input the student's date of birth in the designated format.
  5. Read the statement about applying for testing accommodations carefully, indicating your understanding and agreement to the necessary releases of information.
  6. Affirm the authorizations granted to the school and ACT by signing in the designated area marked 'Student’s Signature.'
  7. If the student is under 18, a parent or guardian must sign in the 'Parent/Guardian’s Signature' area.
  8. Enter the date when the signatures were obtained.
  9. Once all fields are complete, review the information for accuracy before proceeding to save, download, or print the form as needed.
  10. Finally, follow any additional instructions provided for returning the completed form to the appropriate contact, in this case, Jill Kramer.

Ensure you complete all required documents online to facilitate your request for accommodations.

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Submit for Approval To request accommodations, you will need to work with a school official, because the accommodations requested should be similiar to the accommodations you currently receive in school. Accommodations MUST be approved by ACT before testing. A request alone is not enough.

Statement of Consent: I understand that personal information is held about me. I have had the opportunity to discuss the implications of sharing or not sharing information about me. I agree that personal information about me may be shared and gathered from the following agencies:

The Format of Extended Time on the ACT SectionRegular TimeExtended TimeBreak10 min10 minReading35 min55 minScience35 min55 minTotal Time3 hr and 5 min4 hr and 40 min2 more rows

Considerations in preparing the informed consent document: Elements of consent present. Complete explanations. Lay language. Protection of confidentiality. No unproven claims of effectiveness. Device studies include a statement that the study includes an evaluation of the safety of the test article.

Special Testing Accommodations Extended time beyond 50% (i.e., double time) Testing over multiple days. Alternate test formats (audio, braille, read out loud) Extended time for the ACT essay. Use of a computer or scribe for the ACT essay.

Considerations in preparing the informed consent document: Elements of consent present. Complete explanations. Lay language. Protection of confidentiality. No unproven claims of effectiveness. Device studies include a statement that the study includes an evaluation of the safety of the test article.

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